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© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
Andreas Fryszer / Rainer Schwing
Handbook of Systemic Psychotherapy
Vandenhoeck & Ruprecht © 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
With 30 Figures and 14 Tables Bibliographic information published by the Deutsche Nationalbibliothek The Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data available online: http://dnb.d-nb.de. ISBN 978-3-525-40453-9 ISBN 978-3-647-40453-0 (ebook) © 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen / Vandenhoeck & Ruprecht LLC, Bristol, CT, U.S.A. www.v-r.de All rights reserved. No part of this work may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without prior written permission from the publisher. Printed in Germany. Translated und typesetted by Satzspiegel, Nörten-Hardenberg Printed and bound in Germany by e Hubert & Co., Göttingen Printed on non-aging paper.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
Contents
Contents
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 1 Peeking Inside the Box: What’s There and What’s Where . . . . . . . 16 1.1 An Outline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 1.2 The Formal Layout of the Texts – Notes for the Reader . . . . . . 17 1.3 Our Position: Shish Kebab Yes, Goulash No . . . . . . . . . . . . 18 2 Exploring, Observing, Beginning
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2.1 What to Expect: The Initial Phase . . . . . . . . . . . . . . . . . 21 2.2 What Is a System and Who Belongs to the System? . . . . . . . . 22 Background Text: The Term “System” and Its Constructions . . . . 22 2.3 Preparing for a Conversation: Facts, Positions . . . . . . . . . . 2.3.1 Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . Background Text: Facts – Is There Such a Thing as Objectivity? 2.3.2 Points of View . . . . . . . . . . . . . . . . . . . . . . . Background Text: Differences Provide Information – and Information Makes Change Possible . . . . . . . . . . . . . . . 2.4 From 2.4.1 2.4.2 2.4.3
Contact to Contract: Initial Interactions . . . . . . . . . . Structure and Possible Questions . . . . . . . . . . . . . Joining: Warm-up, Becoming Acquainted and Introduction The Referral to Counseling, Clarifying the Contracts and Concerns . . . . . . . . . . . . . . . . . . . . . . . . . 2.4.4 Exploring Problems and Resources . . . . . . . . . . . . 2.4.5 A Contract for Continued Cooperation . . . . . . . . . . 2.4.6 Evaluating the Initial Contact . . . . . . . . . . . . . . . Background Text: Is It Possible to Observe Without Acting? . .
2.5 Observing Behavior and Interactions . . . . . . . . . . . Background Text: To Interview or to Facilitate Enactment? 2.5.1 Behavioral Patterns . . . . . . . . . . . . . . . . . 2.5.2 Interactions: The Social Dynamics of a System . . . Background Text: What Are Interactions? . . . . . . . . .
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2.5.3 The Group as a System: Interaction as the Key to Social Dynamics . . . . . . . . . . . . . . . . . . . . . . . . 2.5.4 Behavioral and Interaction Sequences . . . . . . . . . . 2.5.5 Roles . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 Observing One’s Own Physical and Emotional Reactions
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3 Processing, Analyzing and Visualizing Information . . . . . . . . . . 57 3.1 The Genogram . . . . . . . . . . . . . . 3.1.1 Notes on Constructing a Genogram 3.1.2 Genograms: Two Examples . . . . Background Text: Contextualization . . .
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3.2 Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2.1 Functional and Dysfunctional Relationship Structures According to Minuchin . . . . . . . . . . . . . . . . . . . Background Text: What Is a Structural Approach? . . . . . . . . Background Text: Normative or Neutral Perspectives . . . . . . . 3.2.2 Remarks on Using the Map . . . . . . . . . . . . . . . . . 3.2.3 Action Possibilities: Dealing Creatively with Difficult Triads
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3.3 Family-Helper Map . . . . . . . . . . . . . . . . . . . . . . . Background Text: First- and Second-Order Cybernetics . . . . . 3.3.1 Drawing Up a Family-Helper Map . . . . . . . . . . . . 3.3.2 Notes on Registering the Informal Helpers . . . . . . . . 3.3.3 Notes on Registering the Professional Helpers in the Map 3.3.4 Key to the Family-Helper Map . . . . . . . . . . . . . . Background Text: On Neutrality . . . . . . . . . . . . . . . . .
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3.4 Timeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Background Text: Contextualization – The Temporal Dimension 85 3.4.1 Designing the Timeline . . . . . . . . . . . . . . . . . . . 86 3.4.2 Working Together with the Client on a Timeline . . . . . . 86 3.5 Sociograms: The Group as System . . . . . . . . . . . . . . . . . 88 Background Text: Sociometry and Group Dynamics Were the Earliest Approaches to Systemic Thought . . . . . . . . . . . . . 90 3.6 Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.1 Criteria for a Good Report . . . . . . . . . . . . . . 3.6.2 What Dimensions to Include in the Report . . . . . . 3.6.3 Progress Reports for Evaluation Purposes and Planning Interventions . . . . . . . . . . . . . . . . . . . . .
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4 Making Decisions: Preparing a Contract, Setting Goals, Planning Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 4.1 The Contract Is the Basic Guiding Principle of Systemic Work . . 99
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Background Text: Why Do Systemic Therapists Speak of Contracts and Concerns? . . . . . . . . . . . . . . . . . . . . 4.1.1 How to Set up a Contract . . . . . . . . . . . . . . . . . 4.1.2 What Does a Contract Contain? . . . . . . . . . . . . . . Background Text: Noncompliance with the Contract . . . . . . . 4.1.3 System Politics: Open, Hidden, Contradictory and Ambivalent Mandates . . . . . . . . . . . . . . . . . . . Background Text: In Praise of Hidden Mandates; or: How to Slowly Melt an Iceberg . . . . . . . . . . . . . . . . . . . . . . 4.1.4 Complaining Clients: Listening as Mandate . . . . . . . . 4.1.5 Draftees: When Others Are More Motivated than the Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1.6 Control as Mandate: When Counselors Must Be More Motivated than their Clients . . . . . . . . . . . . . . . . 4.1.7 A Method for Resolving the Mandate Matter: The Carousel 4.1.8 Does the Mandate Match the Offer? . . . . . . . . . . .
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4.2 Generating Hypotheses and Summarizing a Working Hypothesis Background Text: Why Do Systems Theorists Prefer to Speak of Hypotheses and Not of Diagnoses? . . . . . . . . . . . . . . . 4.2.1 The Sources and Themes of Hypotheses . . . . . . . . . . 4.2.2 How to Construct Hypotheses . . . . . . . . . . . . . . . 4.2.3 Three Practical Tips . . . . . . . . . . . . . . . . . . . . Background Text: In Praise of Hypotheses – and the Demonizing of Hypotheses by the Followers of “Not-knowing” . . . . . . . .
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4.3 Preparing Hypotheses When Working with Foreigners
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4.4 Defining Good Goals . . . . . . . . . . . . . . . . . . Background Text: Goal-Oriented Approaches – or: Does Perturbation Stimulate Open Processes? . . . . . . . . . 4.4.1 Criteria for Formulating Goals . . . . . . . . . . 4.4.2 Goals for Placing Children in Foster Homes . . . . 4.4.3 Describing and Using Goals: Two Instruments . . 4.4.4 Planning and Evaluating Interventions . . . . . .
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4.5 The Group as a System: Constructing Hypotheses . . . . . . . . 4.5.1 Different Group Contexts, Different Demands on Counselors . . . . . . . . . . . . . . . . . . . . . . . . . 4.5.2 Hypothesis: Too Little or Too Much Cohesion . . . . . . . 4.5.3 Hypothesis: Destructive Group Dynamics . . . . . . . . . 4.5.4 Hypothesis: Too Few or Too Many External Limitations 4.5.5 Hypothesis: Different, Contradictory Values and Interests 4.5.6 Hypothesis: “Alpha” Stands for the “Wrong” Values and Interests . . . . . . . . . . . . . . . . . . . . . . . . . . 4.5.7 Why Develop Such Normative Hypotheses? . . . . . . .
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5 Acting: Intervening and Accompanying Processes . . . . . . . . . . Background Text: Inducing the New – Where Does Change Begin? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Background Text: Solutions Are Important – And so Are Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 Sculptures: Three-Dimensional Metaphors . . . . . . . . . . . . 5.1.1 Sculpture as a Metaphor for Relationships Background Text: The Value of a Sculpture . . . 5.1.2 Verbal Metaphors as Sculptures . . . . . . 5.1.3 Sculpture as a Metaphor for Time: Memory
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5.2 Extensions: Sculptures in Different Settings . . . . . . . . . . .
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5.2.1 In Individual Therapy: Social Atom and Chair Sculptures 5.2.2 The Family Board . . . . . . . . . . . . . . . . . . . . 5.2.3 Symbol Sculptures . . . . . . . . . . . . . . . . . . . . 5.2.4 Working with Sculptures in Case Reviews . . . . . . . . 5.2.5 Sculptures in Family Reconstructions . . . . . . . . . . Background Text: Systemics and History . . . . . . . . . . . . 5.2.6 Systemic Structural Constellations . . . . . . . . . . .
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5.3 Circular Questioning . . . . . . . . . . . . . . . . . . . . . . .
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5.3.1 How to Construct Circular Questions . . . . . . . . . . . Background Text: What’s So Circular About Circular Questioning? . . . . . . . . . . . . . . . . . . . . . . . . . . . Background Text: How Circular Questioning Works . . . . . . . 5.3.2 Problem and Resource Contexts: Using Circular Questions 5.3.3 Two Suggestions for Dealing with Circular Questions . . .
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5.4 Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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5.4.1 Normalizing . . . . . . . . . . . . . . . . . . . . . . 5.4.2 Paying Compliments and Activating Resources . . . . 5.4.3 Reframing: Changing Your Reality by Changing Your Description . . . . . . . . . . . . . . . . . . . . . . 5.4.4 Ambivalent Comments (Paradoxical Intention) . . . . Background Text: On Paradoxical Mandates and Paradoxical Interventions . . . . . . . . . . . . . . . . . . . . . . . . .
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5.5 Witnessing . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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5.5.1 Expanding the Perspective of the Client System . . 5.5.2 Inner Authorities, Role Models and Critics . . . . 5.5.3 Sympathetic Companions . . . . . . . . . . . . . 5.5.4 Cultural Perspectives in Intercultural Counseling . Background Text: Studying, Creating and Deconstructing Constructions . . . . . . . . . . . . . . . . . . . . . .
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Background Text: Helping in Word and Deed: Is That Still Systemic? . . . . . . . . . . . . . . . . . . . . . . . . . . 5.6.1 Personnel: Who Gets Invited? . . . . . . . . . . . . . 5.6.2 Initial Encounter: The First Few Minutes . . . . . . . 5.6.3 Using Vehicles: Working Directly on the Scene . . . . 5.6.4 Changing Spatial Constellations – Working with Limits 5.6.5 Presenting the Situation: Staging and Enactment . . .
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5.7 Modelling Contexts: Network . . . . . . . . . . . . . . . . . .
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5.8 Externalization . . . . . . . . . . . . . . . . . . . . . . . . . . Background Text: How Do Externalizations Work? Plus: A Warning! . . . . . . . . . . . . . . . . . . . . . . . . . . .
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5.9 Metaphors and Stories . . . . . . . . . . . . . . . . . . . . . .
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5.10 Between Sessions . . . . . . . . . . . . . . . . . . . . . . . .
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Observational Tasks . . . . . . . . . . . . . . . . . . . Ambivalence Tasks: “Do nothing!” or “More of the same!” Change Tasks . . . . . . . . . . . . . . . . . . . . . . Rituals . . . . . . . . . . . . . . . . . . . . . . . . . . Practicing New Behaviors . . . . . . . . . . . . . . . .
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5.11 Accompanying and Supporting Changes . . . . . . . . . . . .
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How to Be Supportive . . . . . Cheerleading and Asset Growth A Climate of Change . . . . . On Relapses and Incidents . .
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5.12 Leave-Taking and Final Phases . . . . . . . . . . . . . . . . .
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5.12.1 The Dynamics of Parting Processes . . . . . . . . . . . Background Text: Phases in the Process of Leave-Taking . . . . 5.12.2 Shaping the Final Phases . . . . . . . . . . . . . . . .
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5.13 When Is it Best to Do What? Is There Such a Thing as a Typical Course? . . . . . . . . . . . . . . . . . . . . . . . . .
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6 Positions, Values and Roles in the Systemic Trade . . . . . . . . .
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6.1 Positions and Values . . . . . . . . . . . . . . . . . . . . . . .
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6.2 Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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6.3 The Role of the Counselor: Teacher, Facilitator, Consultant, Evaluator . . . . . . . . . . . . . . . . . . . . . . . . . 6.3.1 Teacher . . . . . . . . . . . . . . . . . . . . . . . 6.3.2 Facilitator . . . . . . . . . . . . . . . . . . . . . . 6.3.1 Consultant . . . . . . . . . . . . . . . . . . . . . . 6.3.1 Evaluator . . . . . . . . . . . . . . . . . . . . . .
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References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Index
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© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
Preface
Preface
Preface
Some 20 years ago a few colleagues active in social education asked Winiger Beuse about obtaining training in systemics that would not be limited to simple therapeutic know-how, but rather concentrate on imparting the knowledge necessary for working professionally in social welfare and in healthcare. At that time there were few opportunities of this nature, at least not in that particular geographic area. Most courses in continuing education were more of a clinical nature – even if they did contain the word “counseling” in their title. The methods taught there tended to stem from therapeutic settings and were designated solely for therapeutic situations. Our observations both as therapists and as teachers of various training courses in family therapy had led us to the conclusion that systemic approaches could be very enlightening when reflecting on psychosocial work, the more clinical approaches failing to be particularly relevant in such contexts. From this original inquiry arose the idea of creating just such a curriculum. To this end, four teaching therapists (Winiger Beuse, Erika Lützner-Lay, Artur Goerke-Hengst, Rainer Schwing), up to that point only a loose-fitting network, sat down together to draw up a 2-year course in continuing education. The course was based on the needs of the original group and on their own experiences during training courses. The goal was to create specialized systemic know-how for the field of social work, for experts in the field of healthcare, and for educational institutions. From this interaction – and from the growing pool of teaching experiences – arose the “praxis – institut für systemische beratung” (“praxis – institute for systemic counseling”). Today we can look back on 18 years of experience with this curriculum and on 40 different training groups. We now have a wealth of literature available on systemic approaches in many different disciplines. There are also excellent basic works available on the market outlining systemic practice and describing various methods. Yet few methodological textbooks exist that describe the whole complexity of psychosocial practice and the practical methods available for the various fields. That is why we decided to draw from our own materials, which arose in part through our interaction with participants in supervision and training courses and have been thoroughly tested and fine-tuned in the course of their participation. Our goal was to prepare a collection of methods to be put again at their disposal. We were very pragmatic: We wanted our colleagues in these courses to have a collection of tools they themselves could employ when working with groups from all sorts of fields (inpatient, outpatient, semi-residential). The participants of these courses tend to come from many different areas, such as caretaking, coun-
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
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seling, or support of both individuals and groups: They are the ideal recipients of our package of systemic tools. And, not least, we want to address the needs of students and trainees in the social, educational and therapeutic professions who need practical depictions to prepare them for the daily work ahead of them. Of course, not every method is appropriate for every situation. Anyone attempting to put the methods presented here into practice stringently will encounter be met with above all one reaction: resistance. The better choice is to pick the methods wisely and narrowly to fit the client in question. An interview does not automatically become systemic, or, for that matter, good, simply by asking a copious amount of questions. Rather, the method must be adapted to one’s own role and to the circumstances. A further reason for writing this volume was to demonstrate the diverse tools that have emerged from the various different systemic traditions. In our opinion, the conscious combination of diverse approaches – under consideration of the respective theoretical background – will be the future method of choice. The latter conviction has largely determined the structure of this book, as detailed explicitly in the first chapter. We sometimes wander back and forth between male and female designations in an attempt to include both sexes in our remarks. The most important thing, however, is the following: No thought, and certainly no book, is the work of single individual or even two. Many different people participated directly or indirectly in the development of this volume: Our families, who have accompanied our work with patience and support; trainers and colleagues at our institute, from whom we have learned so much – and who make our work so pleasurable; the scientific board of our institute, which has contributed many suggestions and much support particularly in difficult times; our readers, who have provided critical thoughts, both positive and negative; our clients, colleagues, and customers with their valuable feedback. In particular we thank Inge Liebel-Fryszer, Franca, Lina and Leon Fryszer, Eugenia Schwing, Erika Lützner-Lay, Winiger Beuse, Artur Goerke-Hengst, Verena Krähenbühl, Dr. Margarete Hecker, Prof. Dr. Nossrat Peseschkian, Ruth Heise, Ingrid Sorge-Wiederspahn, Marika Eidmann, Heike Schwarz, Hans-Werner Eggemann-Dann, Cordula Alfes, Irma Schnocks, Anja Deger, Carole Gammer, Rainer Bosselmann, Antony Williams, Jürg Hartmann, Carl Wörner, Dr. Fritz Glasl, the Caritasverband Frankfurt and the team at the Eltern- und Jugendberatungsstelle Stadtmitte, the team at our own praxis institut, the former Psychologisch-Pädagogisches Zentrum (PPZ e.V.) and its employees as well as our clients, colleagues and customers from whom we have learned so much. A comment regarding the English translation of our book: literature which has previously been published in English is quoted following the original translation. Excerpts taken from literature which has only been published in other languages have been translated by us into English. For some interviews, we were unable to find some of the original English versions of the German translations and thus used our own English translations. These may deviate from the English original, even though the interviews were originally conducted in English.
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We would like to express special thanks to our translator, Joseph A. Smith, for his competence and dedication – and his patience with our many questions. We also thank Emily Falkenberg for her efforts and for the many discussions we had with her to clear up questions surrounding English and American technical terms. Günter Presting at our publisher, Vandenhoeck & Ruprecht, is also due many thanks for supporting this project so heartily and with great commitment and for encouraging us all the way. Special thanks go to our parents for the foundations they laid that have made this book possible. Andreas Fryszer and Rainer Schwing
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
Foreword
Foreword
Foreword
This is the book I would liked to have written myself from my own experience in the teaching and continuing education of social workers and social educators. Unfortunately, because of other personal and professional commitments, that was not possible. All the more I would like to congratulate Rainer Schwing and Andreas Fryszer, who have drawn on their own wealth of experiences in the supervision of helpers of all sorts to compose this handbook containing a plethora of practical approaches to comprehending and reacting to even the most complicated and problematic situations. They show how systemic theory and systemic practice can impart to professionals from various fields a pragmatic and helpful approach to both solving concrete problems and understanding the general theory of social work. How often have we, as university instructors, been told that the therapeutic concepts and the many case histories provided in our courses were interesting, albeit of little practical use under real-world circumstances. That can be a very frustrating experience, to say the least. This book employs an abundance of case histories that, like the systemic concepts originally developed in clinical surroundings, can be transferred to all sorts of areas where helpers are employed. A rather gloomy mood ensues among social workers and social educators when they get together and discover how very little they can actually effect in their professions, how overworked they all are, and how little solidarity they experience from others. This volume, on the other hand, often speaks of resource orientation and how new approaches and new concepts can provide both satisfaction and pleasure at work – all the while strengthening one’s competence. Colleagues react particularly positively to the simplification gained through the use of the legendary “Philadelphia Map,” where one enters the various hierarchies, relationships, and the systemic structures experienced. This map is meant to be understood as a provisional, experimental diagnosis – not a final one – that may change in the course of the helping process: The client is not labeled or reduced to some scheme. A further example: Finding a diagnosis and initiating an intervention are not treated as separate entities; there is no need for a long preparation for the exploration – the process of change commences immediately after the “joining” begins, i.e., the first contact between counselor and client. This approach bolsters one’s courage to attack even more complex, perhaps even stalemated client systems. This book offers its readers many pragmatic suggestions and imaginative ways to induce change, such as reinterpretation, positive connotation, telling stories or inserting rituals in systems with aberrant behavior. That is not to say that the
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Foreword
reader is presented with a magical grab bag of solutions to choose from. Rather, the “how” of systemic therapy always lies at the forefront; systemic thought and action patterns are presented as concrete events emerging from theoretical foundations, thus preserving the close relationship between theory and practice. We know from the many comparative studies the question of why various types and schools of intervention succeed (or don’t) that success depends greatly on the personality and the credibility of the respective counselor – and on that person’s emotional identification with his or her own method. The hand that holds the tool is decisive. This book does not have a chapter devoted exclusively to the personality of the counselor, but the many case examples highlight how important the esteem of the counselor for the client is in an emotional emergency; and how carefully and cautiously the proper type of intervention must be chosen. A practitioner wanting to become better qualified in systemic concepts and the systemic approach will find many references to the fact that the “map” one constructs to better understand the client is not the same as the actual situation itself, which in fact may be very different from the construction used to help understand that person’s situation. However intensely one may choose to apply previously unknown or unusual intervention methods, when observing the client system it is imperative to ask oneself the following: What type of feedback am I getting from the client and how sensitive am I toward those signals? The German-speaking countries have had at their disposal a number of good and proven theoretical textbooks on systemic therapy and counseling. We learned a great deal from the American pioneers, who in the 1950s and 1960s began to look beyond the individual and expanded their view to clients in their respective contexts. Andreas Fryszer and Rainer Schwing have written a handbook that deals, in depth, with the current social, legal and institutional situation readers face throughout their lives and work in Germany today. The case studies comprise all social strata, from the unstructured poor family relying on help from a social caseworker, to the middle-class family seeking help from a counseling center, to a dysfunctional team from a highly structured administrative setting. The need for more experienced practitioners is becoming ever stronger because of the social precariousness now found in the poorest areas of large cities. I hope this book will be widely read by colleagues from social work and social education, by psychologists and psychiatrists alike, indeed by everyone working in the business of caretaking. I hope they can integrate the help, suggestions, and options provided here to manage their daily tasks. By strengthening their skills and competence they can contribute to furthering an appreciation for their professions – something that is sorely needed in light of the increasing social fracturing occurring in broad parts of the population. Margarete Hecker
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1 Peeking Inside the Box: What’s There and What’s Where
1.1AnOutline
1 Peeking Inside the Box: What’s There and What’s Where
1.1 An Outline Anything we do – and thus of course anything we do professionally – begins with a series of things we see, organize, and decide upon. Ideally, that process would look like the one depicted in Figure 1.
Figure 1: The (ideal) linear course of seeing, organizing, deciding, and acting.
In fact, however, action often takes place first, before we’ve even seen and understood why we acted in such a way. And, alas, the same is true for professional dealings. The reverse order is often necessary because of the way the situation unfolds. And sometimes seeing, organizing, deciding, and acting can all occur simultaneously. Systemically speaking, this course may be considered a circular one that compresses the four steps into ever-shorter cycles. Circular in this regard means the opposite of linear – which introduces us to an important pair of opposites in the systemic way of viewing things: Linear means a temporal succession – first seeing, then organizing, then deciding, and finally acting. Every step is the result of the previous one: Seeing is the prerequisite for organizing, organizing is the prerequisite for deciding and so on. Circular, on the other hand, means mutual dependency, an interconnectedness. Seeing can arise from organizing, deciding can follow action. The order in which things occur does not necessarily adhere to the causal context; rather, the various elements mutually influence each other. Every beginning and thus every end, every form of punctuation in such a circular process is arbitrary (see Figure 2 as well as the Background Text in Chapter 5.3). In this respect, the quote by Heinz von Foerster is valid: “If you desire to see, learn how to act” (1984, p. 61). This book deals with the conscious reflection, organization and planning of these steps when working with families, groups and individuals. It depicts the ideal phases of an intervention process, the goal being to show how this order of things works from a systemic point of view:
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1.2 The Formal Layout of the Texts – Notes for the Reader
Figure 2: The circular approach to seeing, acting, organizing and deciding.
– – – –
Seeing: exploration, diagnostics, initial interview (Chapter 2), Organizing: data analysis and documentation (Chapter 3), Deciding: devising hypotheses, setting goals, planning interventions (Chapter 4), Acting: intervening and accompanying (Chapter 5). 1.2 TheFormalLayoutoftheTexts–NotesfortheReader
1.2 The Formal Layout of the Texts – Notes for the Reader It is our goal to present the tools of systemic therapy so that any practitioner can follow and implement them. We describe the individual methods in detail and provide additional extensive notes and instructions that have proved to be useful in practice. To this we add many examples drawn from practical experience. All examples have been modified to prevent any reference to actual persons or situations. The use of certain tools is inherently connected to the systemic perspectives behind the methods set forth. Thus, employing these tools simultaneously supplies the user with an introduction to systemic perspectives, basic approaches and theoretical considerations. Only the repeated use of such a skill will turn it into one’s very own skill – something true of therapists and craftsmen alike. In addition, we emphasize these skills by putting them in special sections titled “Background Texts,” which serve to present basic systemic tenets and theoretical concepts to the reader as well as to show the connection between the practical application and the ideal or historical background of systemic work. Conversations with students of systemic thought often yield a number of main
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1 Peeking Inside the Box: What’s There and What’s Where
questions: What exactly makes a method systemic? And what are the ideas behind this approach? These questions further the discovery one’s own identity as a systemic-oriented helper. Methods and techniques enable us to carry out specific actions, much as hammers, pliers, and welding equipment do. Glasses, microscopes, telescopes, and infrared cameras all help us to perceive our environment. Theoretical positions train our vision of the world around us – they are as it were the glasses that allow us to focus on the various levels of social systems. In this sense not only methods and techniques, but also theoretical constructs are tools of perception and should be treated as such. Their usefulness depends on the situation, the persons in question and the goals at hand. Their usefulness, in turn, determines whether a particular concept, a method or a technique should be employed or not (see HerwigLempp, 2012, p. 44). Thus, in the “Background Texts” we introduce various, not necessarily compatible theoretical positions and invite the readers to choose for themselves, depending on the respective situation. Yet, what we do not provide is a complete and self-contained presentation of the theory of systemic principles. To that end there are a number of very good and competently written publications (e.g., von Schlippe & Schweitzer, 2007). One central matter is of utmost importance to us: We want to support students in the application and use of systemic thought in their daily work and provide more experienced practitioners with a handbook of useful suggestions. The “Background Texts” can be skipped by the more skilled and practice-oriented readers already familiar with the various theoretical viewpoints. Nevertheless, we consider it important that the reader be aware of his or her own implicit assumptions about how the insight these tools yield, where their true value lies and how they work. We encourage readers to combine different methods while consciously dealing with their implicit assumptions (the so-called shish kebab principle: putting anything you like and anything that fits on a skewer), but are opposed to the generous use of tools without a clear notion of their theoretical background (the goulash principle: put everything into one big pot and stir). 1.3 OurPosition:ShishKebabYes,GoulashNo
1.3 Our Position: Shish Kebab Yes, Goulash No A look at the articles, books and the curricula available for continuing education concerning systemic topics may create the impression that systemic therapy or counseling refers solely to a set of methods and nothing else. Aren’t systemic therapists the ones who pose circular questions, explore narratives and want nothing to do with real problems? Aren’t they always interested first and foremost in exceptions and miracles? Every systemic theory, like the theories of other therapeutic schools, wants to develop its own methodology. Yet such a restrictive approach tends to hinder more than help us to benefit from the cornucopia of methods, techniques and
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1.3 Our Position: Shish Kebab Yes, Goulash No
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theories that have arisen throughout the history of systemic thought. Moreover, it is inadequate for the broad range of demands of the diverse people we meet in psychosocial work. We understand the systemic pursuit to be primarily one of action; it provides us with the orientation necessary to form hypotheses and to plan interventions. This perspective encompasses many ways and methods of understanding the situation garnered from systemic and other traditions. Working with colleagues from various disciplines and with very diverse backgrounds has enlightened and encouraged us. The psychoanalytic approach of understanding events as “scenes” can enrich systemic work enormously; exercises from behavioral therapy can be integrated into systemic intervention quite well. In the appropriate dosage, methods from psychodrama and gestalt psychology can lead to a better understanding on a nonverbal level and can help to implement change. The common denominator remains the systemic perspective: always viewing the entire field and determining the impulses that a certain intervention creates or obtains in a specific context. Our previous 20-year experience in supervision, training, and in organizations from diverse fields has showed us that it is rarely possible to implement the theories of any one school of systemic thought in its purest possible form – and that this, in fact, is not even attempted. A situation is usually characterized by a combination of various forms of therapy and counseling – something we consider both appropriate and adequate. In school one should learn for life – and not learn how spend life playing school! In our opinion, the future of therapy and counseling lies in the combination of the various schools, methods and techniques. Especially more recent publications point in that direction, such as the development of the “generic principles” by Schiepek and others (see Introduction to Chapter 5 on intervention). These resemble the principles formulated by physicists which initiate processes of change in self-organizing systems (see Haken & Schiepek, 2010). Chapter 5 also discusses the determinants of change set forth by Grawe. In his work, Grawe compares different types of therapy which are now found in many modern approaches. The results of Schiepek and Grawe are amazingly similar in nature and confirm our own experiences in therapy and counseling with social systems. We take this as encouragement for combining the various approaches, methods, and views from the different schools of thought both within and outside of systemic theory. Thus, we choose the shish kebab: picking and choosing the best and most tasty morsels that fit together on one single skewer.1 We do, however, think it is still necessary to understand the background of the respective tools, that is, to know why this method or that method should produce some particular change. Any user of such methods will want to know just how the respective theory defines things such as “knowledge” or “truth,” and how that affects the relationship between the client and the therapist:
1 Our thanks to our colleague and teacher Dr. Rainer Bosselmann for this metaphor.
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– How much respect does the therapist have for the framings and viewpoints of his or her clients? – How sure is the therapist about possessing a valid norm or truth – how systems function – so that life may be successful? – How sure is the therapist that “reality” and “system structures” can be recognized as something real?
These points should be kept in mind when employing the methods of the various approaches. The answers to these questions may differ considerably from school to school – and indeed sometimes differ even within approaches to systemic thought, especially in the newer approaches. But they are all relevant to the way the client-therapist relationship is structured. If this point is not heeded, one effectively puts the tools and views of many different schools of thought indiscriminately into one pot. That would be the goulash method of consultation. Thus, we prefer shish kebab over goulash! Even though we realize that one cannot resolve all the contradictions between the different approaches. A normative approach, such as that of Salvador Minuchin, and a narrative approach, such as that of Steve de Shazer, are and always will be opposites and mutually exclusive. But here, too, we can learn from physics: Whether light consists of an electromagnetic wave or particles of material is not completely known, although the two opinions are mutually exclusive. Yet some phenomena can best be explained with the one theory, others with the other theory. Physicists thus tend to change their views on the explanation depending on the respective situation! We like this pragmatic strategy regarding various schools and opinions. In our own practice, we apply a theory as long as it proves to be profitable. We would rather change our theoretical frame of reference during counseling than doubt the ability of our clients to develop and to change, just because we have failed to achieve change with our previous viewpoint.
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2 Exploring, Observing, Beginning
2.1 WhattoExpect:TheInitialPhase
2 Exploring, Observing, Beginning
2.1 What to Expect: The Initial Phase The initial phase is concerned with building up trust among the persons involved, establishing relationships, and gathering information in order to reach an agreement about the type of help to be offered and the goals of that cooperation. The best term to describe this process is “exploration,” which comprises both investigating and examining. In this phase the counselor first looks, listens and observes (in a passive-receptive way), but then also approaches the client – to question, investigate and examine the situation. It is especially important to establish contact with the client: open doors, build bridges, gain trust and provide confidence. The following matters are of primary concern: – Who belongs to the client’s system? – Who is in need of help? Who is most motivated? – What resources are available? – What are the problems and deficits? How are they – and their causes – seen by the various persons involved? – What does one learn from the conversations about the structure, rules and internal communication of the system? – What are the first (nonverbal) impressions of the client’s system and the client’s extended environment? Only after having answered these questions can we formulate possible ways to help the client and, together with the persons involved, determine whether and how their expectations can be met by our offer. There are situations in which the exploration phase will go on for a long time and require multiple meetings both with the persons involved and with other potential helpers. The themes of such meetings may be centered around conversations or any other activities such as playing, hobbies or taking long walks. In other situations a single interview of an hour or so may suffice to reach a conclusion of whether and how to proceed. Depending on the institution involved, the recipient of the offer for help may not be the actual person footing the bill. This creates triangular relationships consisting of the recipient of the support efforts, the actual contractor, and the person or institution providing the support. That may make several discussions necessary – with all three parties, with only the recipient, or with only the contractor. The contractor and the provider must reach an agreement about how to proceed, for
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example, when the family’s bills are being paid by a welfare agency or when the head of an institution is looking for a team supervisor. Some activities demand very intensive preparations with the client’s system to ensure that it is ready and willing to make a contract with the counselor. With clients who have multiple problem areas, the counselor may need a long time to judge how best to offer such help. Regardless whether the initial contact takes only a single meeting or a sixmonth period of preparation, the contents of this phase is basically always the same. 2.2 Wha tIsaSystemandWhoBelongstotheSystem?
2.2 What Is a System and Who Belongs to the System? Whenever we want to observe a system, a number of questions arise: How do I recognize a system when I see one? Who belongs to the system and who doesn’t? What am I actually observing when I observe a system? Does the biological father belong to the system when he has had no contact with his son for over 5 years? What about the deceased grandmother whose influence is still very much palpable within the family? How to classify the teacher who has been so intensely active on behalf of the family the past couple of years? How does one recognize the boundaries of the system? What should be taken into consideration if we are to understand and observe a group of persons as a system?
Background Text: The Term “System” and Its Constructions How can I really know who belongs to a system and who doesn’t? How do I recognize a system? What is a system anyway? First, the bad news for all systemic counselors: There are no such things as systems! And now for the good news: That is why we can conceive of an unlimited number of systems, the only requirement being that a system is – in the end – meaningful! Our definition of who belongs to a specific system must enable us to work successfully on that case. Otherwise, we need to change our view of the system and create a new approach. The criterion for determining the boundaries of a system is not that our definition somehow corresponds to a particular truth, but rather that it is pragmatically useful. The idea behind this thought is: Like any another term the term system is a willful construction. Viewing the world through glasses that see only systems is in fact a conscious decision on our part. It is a way of interpreting the world around us, one that appears to us to be helpful in understanding the world and in developing ideas about how to successfully deal with that world. There are no clear boundaries to systems or subsystems. One family therapist said it very succinctly: “You cannot kiss a system!” Differentiating systems rather serves
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our own orientation; we prepare maps of our experience. Of course, one could draw a particular mountain on the horizon differently. And we have to remember that our drawing of a mountain – no matter how we draw it – is not the mountain itself and never will be. The map is not the same as the landscape itself. And a map is only as good as the orientation it offers us. This approach stems from constructivism (see von Glasersfeld, 2002; Watzlawick, 1977, 1984), an epistemology that assumes that our theories and conceptions of the world are based on our cognitions and can thus never be viewed independently of them. An infrared picture of the earth is not the same as a normal picture, although the object – the earth – is the same in each. What we perceive is very much a product of how we perceive it. We process perceptions and develop from that knowledge our own view of the world – our theories. All of which is dependent on the way our nervous system functions and thus determines how to interpret the information. The “construct” in “constructivism” means that our theories are dependent on our perceptual and cognitive apparatus – and are not necessarily reproductions of an external reality. Maturana and Varela (1992, p. 149) drew the following analogy: “Imagine someone who has spent his entire life in a submarine, has never left it, and was trained to command it. Now from the beach we see the submarine coming closer and gliding to the surface. We radio to the Captain: ‘Congratulations, you’ve avoided all the reefs and have elegantly reached the surface; you’ve maneuvered your submarine excellently.’ The Captain retorts from within: ‘What are reefs and what is surfacing? All I did was pull some levers and turn some switches to achieve certain relationships between the displays and my moving the controls – all in a certain order I am used to. I didn’t do any maneuvering and I don’t know what you mean by submarine.’ “The captain of the submarine sees only the displays of the instruments before him, their actions, and the way in which certain relationships arise. For us, outside the submarine, observing how the relationships between the submarine and its surroundings change, the submarine displays a certain ‘behavior’ that is, depending on the consequences, more or less appropriate. If we stick to our logical approach, we should not mistake the way the submarine works and the dynamics of its conditions with its shifts and movements in the water. “The situation of a submarine with a captain at the helm who is unaware of the outside world is not consistent with what the external observer sees: There are no ‘beaches,’ no ‘reefs’ and no ‘surfaces,’ rather only correlations between displays within certain boundaries. Things such as beaches, reefs and surfaces are valid only for the external observer, not for the submarine and its captain, who is part of that world. What is true for the submarine in our example is also true for all living systems: for the frog with its skewed eye, for Wolf Boy and for every human being alive.”
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Constructivism is not concerned with whether there is a reality beyond our perception. Nor does it dispute the existence of such a reality. The material theories of epistemology, on the other hand, assume a certain material reality beyond our perception and thus do not speak of constructions but of representations of reality. In this sense these representations are either true or false, and they tend to become ever more exact and correct over time, since we continually improve upon how they represent the world. Constructionists, however, do not say whether a construction is true or false. But if we cannot make a statement about the actual existence of reality, how can we judge whether our constructions are correct or incorrect? The main criterion of the constructionist, when judging a theory, is not whether it is true or correct, but whether it is useful and pragmatic. Thus, we can determine who belongs to a system and who does not. It is useless to discuss whether our definition of this system is correct or incorrect. But it is sensible to discuss whether the system we have defined is meaningful, whether it furthers the goals we have set, and whether the boundaries of that system could be set differently to optimize our work. But what does the term system mean? The meaning of system, and social system in particular, may become clearer once one has looked at the following assumptions concerning the characteristics and features of social systems: – Wholeness: “A change in one part of a system necessarily affects the whole system” (de Shazer, 1980, p. 21). All elements of the system are bound together like those of a mobile: The movement of one element defines the movement of all others – and individual movements are transferred to the whole. – Summativity: “The whole is different from the sum of its parts” (de Shazer, 1980, p. 21). There is a different quality to the whole, it is “more”: Music is more than an accumulation of notes; a team can do more and different things than a collection of individuals. – Circular causality, nonlinearity: “The relationship of the progression of cause is such that the initial cause is also affected by the progression itself” (Simon & Stierlin, 2004, p. 393; de Shazer, 1980, p. 21). Events that take place in systems are best described as processes of circular interaction and less as linear processes, which assume a one-way street between cause and effect (see later Chapter 5.3). – Open system: “Organic systems at the level of the cell, complex organism, and population of organisms exists in a continuous exchange with their environment. This exchange is crucial for sustaining the life and form of the system, since environmental interaction is the basis of self-maintenance. (. . .) The idea of openness emphasizes the key relationships between the environment and the internal functioning of the system. Environment and system are to be understood as being in a state of interaction and mutual dependence. The open nature of biological and social systems
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2.2 What Is a System and Who Belongs to the System?
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contrasts with the ‘closed’ nature of many physical and mechanical systems, though the degree of openness can vary, since some open systems may only be responsive to a relatively narrow range of inputs from the environment. Towers, bridges, or even clockwork toys with predetermined motions are closed systems. A machine is able to regulate its internal operation in accordance with variations in the environment may be considered a partially open system. A living organism, organization, or social group is a fully open system” (Morgan, 2006, p. 46). Homeostasis: “The concept of homeostasis refers to self-regulation and the ability to maintain a steady state. Biological organisms seek a regularity of form and distinctness from the environment while maintaining a continuous exchange with that environment. This form and distinctness is achieved through homeostatic processes that regulate and control system operation on the basis of what is now called ‘negative feedback,’ where deviations from some standard or norm initiate actions to correct the deviation. Thus when our body temperature rises above normal limits, certain bodily functions operate to try and counteract the rise, e.g., we begin to perspire and breathe heavily. Social systems also require such homeostatic control processes if they are to acquire enduring form” (Morgan, 2006, p. 46). Diversity demands: This principle “means that the internal regulatory mechanisms of a system must be as diverse as the environment with which one is trying to deal. For only by incorporating required variety into internal controls can a system deal with the variety and challenge posed by its environment. Any system that insulates itself from diversity of the environment tends to atrophy and lose its complexity and distinctive nature. Thus requisite variety is an important feature of living systems of all kinds” (Morgan, 2006, p. 47). System evolution: This principle describes the ability of systems to develop and to change, to “move to more complex forms of differentiation and integration, greater variety in the system facilitating its ability to deal with challenges and opportunities posed by the environment. (. . .) This involves a cyclical process of variation, selection, and retention of the selected characteristics” (Morgan, 2006, p. 47). Observance systems: From the above comments on constructivism results that there is no such thing as an unobserved system. A system is always the invention of an observer. Thus, the observer is always part of the system (see Background Text on p. 22).
Thinking and acting systemically means contextualizing events (see the Background Text on p. 63 and p. 85). A systemic approach sees both the problem and the human being dealing with that problem, both within that person’s context and independent thereof. In this respect, we consider the idea of system as outlined above to be expressly useful and helpful.
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Thus, when approaching a new task we must always define who belongs to the system and who does not. There are no set rules for doing this; there is no “right” or “wrong.” Nevertheless, we are responsible for determining a meaningful allocation that leads to a good result. Case example: In this sense, the nuclear family of the 12-year-old boy whose family was seeking help because of his school problems and dissocial behavior is the system with which we have to work. We can differentiate the son, the daughter and the mother into subsystems, leaving the father somewhat off to the side. The important figures of the maternal grandparents, who exert great influence on the nuclear family, may be seen as the extended familial system, the boy’s school and the Social Services office as independent systems. At this juncture, based on our institutional, conceptional and technical knowledge, we can commence planning how to proceed – whether there should be a long and intensive exploratory phase with many conversations with the parents, the entire family, the grandparents; or whether to begin with just the children, the social services office and the school. Or should we limit our scope to the nuclear family and present a contract after the initial interview? 2.3 PreparingforaConversation:Facts,Positions
2.3 Preparing for a Conversation: Facts, Positions When working with a social system it is important to keep in mind that we are going to hear very different depictions of the same events. Sometimes the members of a system will agree, sometimes not, and sometimes they will be diametrically opposed in both tone and content. Who’s right? Who’s lying? Who sees things with a bias and who sees things “correctly”? Should these matters be discussed in full and resolved – or should we rather avoid such differences since they only lead to quarrels? During the exploration many pieces of information are provided spontaneously or given as answers to direct questions. Differentiating between facts and points of view can sometimes be of great help to us. We consider such a discrimination to be a valuable tool while listening to and subsequently sorting through the information (even if we do revise that statement somewhat in the discussion below).
2.3.1 Facts When interviewing the members of a system, it has proved advantageous to first collect some basic facts about the situation before addressing the positions of those involved. This gives us, as “outsiders,” a better perspective on things. We recommend combining certain questions to create content units. This better frames the situation and helps the others to concentrate on their answers. The following list represents our suggestions based on a family intervention. It shows
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what we mean by “facts.” Of course, the questions can also be applied to other systems such as teams, groups or organizations. – Defining the family system: Who belongs to the family? Who is presently living in the household? Are the family members related to each other? With this information we can prepare a genogram (see Chapter 3.1). – Family anamnesis: What is the background of the family? Where have the children previously lived? Who were the children’s caregivers and at what time in their lives? What were the most important events in the course of the family history (milestones, highlights, stumbling blocks, lucky breaks, fateful events, etc.)? With this information we can draw up and order a timeline (see Chapter 3.4). – Problem anamnesis: This means recording the history of a particular problem. What does the problem consist of? Since when has it been a problem? Did some particular thing happen to trigger the problem? What has had a positive influence on the problem? A negative influence? No influence at all? Most of this information can also be charted on a timeline. – Determining the existing helper system: Who is presently concerned with the case? What is their mandate, goal and approach? Through whom and how did the helper(s) come to be involved? This information can be put into a family helper map (see Chapter 3.3). – Recording previous attempts to solve the problem: What have those persons involved done up to now to solve the problem? Which helpers were previously involved and who asked them to find a solution? How and by whom was (were) the attempt(s) stopped? This information too can be documented in a timeline. Gathering such rudimentary facts not only gives us some initial orientation in a new system, it also allows us to assume the leadership by asking specific and relevant questions. Unlike nondirective counseling approaches, the systemic method is characterized by the counselor controlling the conversation through active questioning. Many clients welcome this approach. For them, the counseling situation is like entering an unstructured, unknown space, which can be disconcerting and cause unease or even fear. This method offers both clients and the counselor a sense of security, and provides the opportunity for everyone to size up each other.
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Background Text: Facts – Is There Such a Thing as Objectivity? The notion of facts suggests that we can discover objective circumstances independent of the respective observer. Yet every fact must first be perceived, analyzed, tagged and finally defined by some concrete person. And then someone has to receive this information, interpret it and evaluate it. How we perceive something, how we interpret it and express it, however, is dependent on the way we generally perceive and process information. This in turn depends on our experiences in life and our own very peculiar and personal approach. The physicist David Bohm, in his volume “On Dialogue” (2004), described in detail the processes that make it impossible to separate the information gathered from the inner states of the person doing the perceiving. Maturana and Varela (1992, p. 32) put it this way: “Everything is said by an observer.” In this sense, there is no justification for speaking of “facts” at all. No information is objective; every piece of information is inextricably fused with the cognitive state and interpretation of the observer and thus subjective. Strictly speaking we are thus always concerned with points of view – never with facts! This state of affairs determines our basic approach: – All statements are subjective viewpoints and not objective facts. – Determining who’s lying and who’s right and who’s wrong is generally moot. – What is interesting and contains the important information are the differences between the various opinions of those involved. They determine how we proceed and how we can help to create something new. With this in mind, we should beware of having a firm opinion of processes in a system when the information at our disposal stems from someone within that system and we have not heard the positions of other members of the system. This piece of advice may seem self-evident and superfluous; but we know from working with helper systems how quickly and confidently professionals make statements about marriages, families or persons within a client’s system although they have in fact never spoken with these people. Even in expert opinions the statements of individual members are presented as facts and form the basis of a professional conclusion and opinions. Here is a further example for differentiating between facts and positions. Regard the following two statements: a) New Years Day is on January 1st. b) My husband is incapable of raising kids. It will generally be easier to have a family agree on the truth of the first statement than of the latter. Especially the father in the family may find it
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difficult to accept the second statement as a fact. But that is exactly what we mean when we speak of the difference between facts and perceptions. Generally speaking, every piece of information is a perception and is thus subjective. In practice, however, it is worth differentiating between relatively unambiguous facts such as the first sentence and positions that concern the task at hand. For our purposes, a fact is above all a piece of information that has been confirmed and agreed upon by the members of a system. When recording the parameters of a system it is important to differentiate between facts and positions to bring some sort of order to a system.
2.3.2 Points of View Once we have gained an initial orientation to the system by collecting some facts, we can turn to the positions of the various family members. Also the positions of the other helpers involved are important. Again, it has proved valuable to pool questions to content units: – Points of view toward the problem: What do the various persons involved (system members, friends, helpers) consider to be the problem? What do they consider to be its origin? Why do they think it would be good for something new to happen? What, in their opinion, would have to happen to make the problem worse? – Suggested solutions by the persons involved: What solutions do the persons involved envision? What could be the first steps in that direction? What would the goal be? What would make things “right”? How would those involved notice that everything is “right”? – Recording the mandates/desires of those involved: What do those involved think the helpers should do and with what goal? How should the helpers proceed and how much should they get involved themselves? What should they rather not do? What would the helpers have to do to be dismissed? – Opinions concerning previous attempts at solving the problem: What do those involved think has resulted from their own attempts at solving the problem? How, why and by whom were previous professional interventions stopped? What have those involved learned from previous interventions (by previous helpers)? What do they criticize about and what was missing in previous attempts? – References to the documentation of positions: The information we obtain from querying the system members about their positions can be documented in the legend of the family helper map (see Chapter 3.3). One’s Own Stance When Asking About Points of View The perceptions voiced will be very diverse and sometimes even contradictory. From the vantage point of the various system members things just look very dif-
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ferent. Here, our own stance during the interview is important in order for the intervention to succeed. – We should not be afraid of these very different and contradictory points of view or of the disharmony – even agitation or animosity – they may cause among those involved. – We need to keep a firm inner stance and conviction that all the different positions are interesting and valuable, and that everyone can learn something from them. – We need to keep a firm inner stance that projects our understanding that different positions are indeed acceptable and normal – even among a group of people who are near and dear to each other. – We ourselves must be convinced that each and every position is valid, that there are no right or wrong positions, but that they are all of equal value. As helpers who actively inquire about the various positions we take responsibility for the interview situation and for what happens among those involved. For this reason it is important to be able to stand up for the approaches taken and to introduce them as the basis for the situation. That creates an atmosphere in which diversity and contradiction do not necessarily lead to denunciation, conflict, triumph or defeat, but rather are allowed to exist side by side in order to be contemplated and accepted. To this end, it may be necessary to intervene if participants try to devalue the positions of others or declare someone a liar because he or she sees things differently. These differences should be viewed against the respective background and in light of the possible consequences. This must succeed, at least in part, – so that the participants are less and not more stressed after the session than before; – so that an atmosphere is created that is conducive to working with the many individual differences of experience, interest and behavior; – because the situation is in fact a litmus test for the trustworthiness of the helper. Can the helper provide sufficient space for each and every opinion, without repercussions for the individual holding that opinion? This matter is of great importance to those involved, and the helper must pass the test.
Background Text: Differences Provide Information – and Information Makes Change Possible This is a very fundamental part of the systemic creed. Systemic theorists always assume that it is valuable to understand differences because they are considered the sources of information that can induce change in a system. Every piece of information represents a difference. The statement “The sky is blue” is possible only because we are aware of things that are not blue. The
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term “sky” is meaningful because we can observe things that are not designated by the term “sky,” i.e., that are differentiated from their surroundings. The Sufis have a nice analogy that contains this thought: “If you want to know something about water, don’t ask a fish.” Experiences other than water are what make it possible to understand the essence of water – an experience fish rarely survive! Tom Waits, the singer-songwriter, expresses this both lyrically and precisely in his song “San Diego Serenade”: “I never saw my hometown until I stayed away too long . . . I never saw the East coast until I moved to the West.” How do social systems change? They usually change through events (births, deaths, weddings, illnesses, divorces, relocations, changes in environment, etc.) – not through counseling. But they also change when members of that system do something different than before, when they change something! And that is precisely the point at which we begin our counseling: We try to influence the persons involved to make them understand that they are in the position to act differently. They can do this only if they see things differently than before – when they give up their previous approaches and develop new ones. To that end, the systems with which we work require new information. But because information means differentiation (see above), we are interested mainly in the differences that arise in the perceptions and positions taken by the members of the system. We may even actively produce new or alternative positions, formulate them ourselves or ask questions in such a way that the system members develop new insights. That is why asking questions about the various perceptions and viewpoints in the group is such an important procedure – at least as important as any of the questions we may pose about facts. Inquiring about positions is especially fruitful for obtaining information when less direct and more circular questioning is employed (see below in Chapter 5.3.1 for a more extensive look at this). Of course, every additional point of view means even more new information. Therefore, it may also be helpful to interview people who are not directly involved but are of great importance to the members of the system: What does the maternal grandmother have to say about the problem and who (in her opinion) should do what to solve it? What would the family pastor think about solving the problem? Such an approach is often called “involving witnesses” (see Chapter 5.5).
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2 Exploring, Observing, Beginning 2.4 FromCo ntacttoContract:InitialInteractions
2.4 From Contact to Contract: Initial Interactions Independent of how the exploratory phase is constructed, there will always be an initial contact. We suggest using a set of guidelines for such conversations. Talking about initial interviews or introductory phases at the beginning of a scientific paper or a systemic training can be a problem: The initial interview and the introductory phase comprise everything that is particular to systemic therapy – its approach to interventions, its points of view, its inner attitudes. Yet all that has to be first acquired. Thus, the following represents a sort of overview for the new student of the systemic approach – to be fleshed out with the later contents of Chapter 5.
2.4.1 Structure and Possible Questions The initial contact with a client or a client system may be broken down into the following phases: a) Joining, warm-up, introduction of the counselor and the counselor’s organization; b) Discussion of the referral and the nature of the concern; c) Exploration of the client’s resources, problem and possible solution(s); d) Arranging a contract; e) Evaluation of the initial contact. These guidelines and suggestions are meant to help frame the initial contact and then to expand it by introducing systemic elements. We do not think it is expedient to employ all of the possible questioning methods during the initial contact. Rather, one can pick and choose areas to be included (and/or excluded) in accordance with one’s own intuitive hypotheses. Depending on the setting, some phases and approaches may be spread out over several sessions or even longer. Or it may be better to set up separate initial contacts with the different members of the system. We sometimes speak of “clients” and sometimes of “client systems” because the guidelines we use in our contacts with individual clients have also proved useful for client systems (families, groups, teams).
2.4.2 Joining: Warm-up, Becoming Acquainted and Introduction Joining means establishing a contact, connecting, getting to know someone in their present situation. We attempt to create an atmosphere that allows everyone to become acquainted with each other; we also try to find the optimal way to approach the client.
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A suggestion: The first step is to engage more or less in small talk – then one can proceed to talk about more personal matters and ask questions that will further the process of mutually getting to know one another. Mutual, in this context, means: Not only do we want to become acquainted with the client system, the client should also learn something about our own personal and institutional background.
The goals and importance of joining: – The clients can slowly get used to the counseling situation – sometimes the mind adapts more slowly than the body. They can orient themselves to the room, the counselor and the entire surroundings. – The counselor takes on the active role of host and shapes the atmosphere and the conversation. – The counselor attunes him- or herself to the clients, listens to them speak, observes their nonverbal behavior, where they sit and how they sit, how they articulate themselves, the words they use. In this way we can adapt to the client’s style (pacing) in order to conduct the conversation (leading). – From a professional point of view we must remember that we are dealing here with the initial meeting of very different human beings. Once we have struck up a conversation with a stranger in a new situation, it is easier to extend the contact. – We keep the threshold low for the various family members to establish contact so that we can gain contact with everyone present. – The clients need not present themselves as somehow “problematic,” but may be seen by others as capable people with their own resources and skills. – The conscious inclusion of children shows everyone present that children and their points of view are welcome. Examples: – The counselor takes a few minutes for small talk and then proceeds to shape the situation: “How was your trip? Was it difficult to find the place? Did it cause a lot of trouble for all of you to come today?” The counselor then provides some own personal information. – The clients are not identical with their problems. Clients have jobs, they like sports, they have hobbies and other resources we should know about. Everyone, even the children, should be asked about the positive aspects of their life, daily routines, interests and opinions. The best topics to choose are those that provide pleasure. – Directed toward the parents: “What do you do for a living? How does that work out for you? What do you do for fun? Who takes care of the children in the afternoon? How do you like your neighborhood? What do you do in your spare time? What hobbies do the other family members have? Where do you go on vacation?” – Directed toward the children: “What do you like to do in the afternoon? What is your favorite subject in school? Do you participate in sports? Where? How does that work out for you? Do you have a lot of friends? Do you enjoy going to (nursery) school? What’s your favorite game? Who’s your best friend?”
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A short introduction of the counselor and the counselor’s institution is useful to acquaint the clients with one’s work and methods. Clients tend not to ask about these matters on their own. The counselor can tell the clients – where they are presently situated; – how the institution functions, what its goals are and what role the counselor plays in the organization, how it is connected with other institutions, how professional discretion works, and how the counselor goes about the task at hand; – what laws and stipulations affect the counselor’s work, the legal and ethical background, when the counselor is required to transfer information and how that is then communicated to the clients; – who pays for the counseling and why.
2.4.3 The Referral to Counseling, Clarifying the Contracts and Concerns One prerequisite for concluding a contract with the client system is determining the mandates. These can be differentiated as follows: – the expectations for the initial interview, – the expectations of the person doing the referring, – the expectations of those present in the room for the assistance they will receive. The latter two points will likely have to be revisited at the end of the initial interview when the counselor and the client/client system make up a contract. The extent to which one can already discuss such mandates at this point depends greatly on the client system. Some clients are under great pressure to report as quickly as possible about what is bothering them – to get to the “real” problem at hand. If you notice this pressure building up, don’t adhere too closely to systematic procedures, but put them off for later discussion. The clients should above all have the feeling that they are being taken seriously. At this point in time it is important to provide a stimulus and to make suggestions about how expectations and mandates can be formulated. Of course, difficult constellations sometimes crop up: expectations that cannot be fulfilled, contradictory or hidden expectations, systems in which everyone wants something different. In Chapter 4.1.3 we discuss in more detail the various possible mandates and present solutions for dealing with them. Example questions for determining the expectations of those present for the initial interview: – How long were you expecting the meeting would last? – What are your expectations for today’s meeting? How would you know at the end that your expectations had been met? (Ask the client for a concrete description!) – What in your opinion should definitely not happen today? – What are you expecting of me as counselor from our first meeting?
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The counselor should also express how he or she imagines the initial contact would occur (time and organization) and what needs to be discussed concerning the respective goals. Important points to be included in agreements between the client and the counselor concerning the initial interview: – How long should the conversation last? Who should learn about its contents? – How far should the client and counselor go in their first meeting and when should they pull back? – What is the counselor responsible for in the first meeting? What role should the counselor assume (or not)? – What should be reached in the end (or not)? The context of the referral and the mandate The situation surrounding the mandate can be very complex since, in addition to the persons present at the sessions, others – individuals as well as institutions and functionaries – harbor their own interests and expectations. Case example: A problem arises in the office of the company president: Three part-time employees share a position in the office. There is no clear hierarchy among the three, which leads to conflict. They can’t work together (forward information, coordinate the filing and ordering of documents, take care of daily business), yet no one wants to assume the overall responsibility – and none of the three is accepted by the others for that position. By now, the president is rather unnerved by all this and wants to clear up the matter in a few joint counseling sessions, so that peace and quiet can rule again. The goal is for everything to run smoothly again on its own. Above all the president wants one of the three (the one she finds most suitable for the job) to be accepted as coordinator. Case example: A juvenile magistrate orders a youth to receive 10 hours of counseling and requests a report should the youth fail to fulfill the court order. Case example: A child therapist refers a family to family counseling because she sees major problems between the parents and considers the father’s parenting methods to be inappropriate and destructive. She expects of the counselor in the family counseling center to try to get the father to adopt another parenting style. The mother likes the support of the therapist and has the same expectation of the counselor. The father is uncertain about why he should even go to counseling, but in the end he comes along. Case example: A company director sends his department managers to supervision counseling because he has noticed deficits in the company’s personnel management and thinks cooperation between the various managers could be improved. The managers themselves would also like to receive some feedback because they, in turn, see problems in the managerial style of their boss. Everyone quickly reaches a consensus that such counseling is sensible and appropriate, without discussing the exact contents and goals of such a step.
The person doing the referrals and other persons in the client system play a major role without even being present at the sessions. These examples show how important it is to determine the parameters:
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– Who made the referral, who suggested, sent, forced, convinced or otherwise motivated the client to go to counseling? – What are the expectations of those doing the referring for how the counseling sessions should be carried out? What do the clients actually know about these motives and what do they presume? – What are the expectations of those doing the referring for the results of counseling? What do the clients actually know about these motives and what do they presume? – How much pressure (and what type) is being applied by the referrer on the client to accept the help being offered? – What would happen if the client failed to come to the counseling sessions? What would happen if the client were to terminate counseling prematurely? – How high is the motivation of the client to attend counseling? – Why did the person doing the referring suggest this particular counselor and what do the clients know or presume about these motives?
The information we gather from the answers to these questions will help us to a) understand the problems and pitfalls of the contractual situation, b) form hypotheses in light of the referral context, c) draw up a contract with the clients which is realistic and viable. Particular attention must be paid to clients who have been “sent” by someone else and whose inherent motivation may lag behind that of their referrer (for more on this point see Chapter 4.1.5). Determining the client’s mandates Here, we discuss how to determine the concerns of those present: – What are the clients concerned about? What do they think should come out at the end of counseling? How do they envision the cooperation during counseling? – What should the helper contribute to the process? How should what sort of support be given? – What should the counselor refrain from doing – and not do under any circumstances – during the sessions? What subjects are to be avoided altogether? – What is the client willing to do? What is the client completely unwilling to do? – How much help should be given? What, for the client, is a reasonable timeframe for reaching a solution? How long, how often, for how long and with what frequency should sessions be held? – What else is important to the client (e.g., information policy)? The answers to these questions should be given by each individual client so that differences in the expectations for counseling become clear to all. We recommend not posing the questions directly, but circularly (cf. Chapter 5.3):
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Case example: “If I were to ask your husband what he expects from counseling, what do you think he would answer?” Case example: “What do you think your wife is expecting from me as counselor? What would I have to do so that she’s happy with my work? From the vantage point of your wife, what should I avoid doing at all costs?”
One can also size up the expectations and mandates of the clients using the miracle question (see the example in Chapter 5.3.2). Mandates Change The therapist should take the client’s mandate seriously at the beginning of counseling and express interest in its realization. Yet one must also remain open to modifications of mandates and reckon with the fact that not all mandates will actually be expressed at the beginning and some may never be put into words because the client is unable to. The way both the client and the counselor view things will necessarily change in the course of the intervention; some matters will become clear(er) as part of the process. As the saying goes, when the tip of the iceberg melts, the first part you see is what was below the waterline. It is not our duty to speculate at the beginning of therapy about what aspects of a possible major problem may or may not be visible. Rather, we must assume that new aspects, questions and themes will become visible on their own as clients formulate their concerns and turn them into new mandates for future sessions. For this process we need the following: – Time during the course of counseling both for ourselves and for the client system to understand everything that is part of the problem, – A willingness to say goodbye to the myth that one can determine the whole breadth of the problem from the very beginning if one is only thorough enough, – Trust in the process of concerted efforts, which allows us to realize that “understanding follows action.”
2.4.4 Exploring Problems and Resources We have now reached the focal point of systemic work. All of the questions we now deal with, in fact, already comprise interventions. For that reason, we present them again in Chapter 5 together with examples. In Chapter 5.3.3 we discuss the various questioning methods used in the initial interview to explore problems and resources. Depending on the information available in advance, the counselor should decide in which direction questioning should go. In our opinion six variations are appropriate for the initial interview (see also Chapter 5.3.2): – Clearly defining the problem and the persons involved, – The dance around the symptom, – The past: history of a problem, – Exploring previous attempts at problem-solving,
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– Differences in explanations for the problem and desirable solutions, – Questions for determining the system’s resources.
2.4.5 A Contract for Continued Cooperation One of the main goals of the exploration phase or the initial interview is to sign a contract with the client (system) concerning the assistance to be given by the counselor. In such a contract the parties agree to what constitutes such assistance, what goals are to be pursued, and how long and under what conditions the cooperation should take place. Chapter 4.1 shows in greater detail what is included in such a contract, what it can mean to the further relationship with the client and the role such a contract plays within systemic therapy. The basis for any such agreement is, first, that the mandates of those doing the referring and of the client have been thoroughly examined with respect to the assistance to be offered. Second, the counselor must have reached an opinion regarding what he can and will offer. Also, the counselor should have developed a first impression and have drafted some hypotheses about the client system in order to make an offer and to reach an agreement with the client. There’s nothing wrong with suggesting two or three sessions for further explorative purposes before reaching a consensus about the full extent of the contract. Client systems, referrals and client histories can in fact be very complex and large. It is better to first gain some perspective – to sleep on it and maybe discuss it with a colleague – before agreeing with the client on a particular setting, on goals and on one’s own personal and professional efforts on their behalf. Once the mandates of those present and not present – i.e., the clients and those doing the referring – as well as one’s own perspective on the case have been cleared up, the contract can be drawn up. It is helpful to write a short summary of all previous results: – A short summary of the exploration of the problem at hand, – A short summary of the expectations of the client and of those referring, – One’s own assessment of what constitutes a meaningful offer of assistance for the client to solve the problem (setting; length, number and type of sessions; goals for the process; tasks and responsibilities of all involved; information management), – The assessment of whether it may be better to refer the client to someone else. Further, it is recommended to clearly point out where the expectations of the client, those referring and the counselor agree and complement each other – and where they disagree. If further cooperation is to occur, then now is the time to arrange a contract as stipulated in Chapter 4.1.2.
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2.4.6 Evaluating the Initial Contact Before proceeding to the next phase, one should take the time together with all participants to evaluate the initial contact and exploration phase, in order to – make clear that the goals and agreements stemming from the initial contact have been observed; – ensure that the counselor has learned whether or not the client is satisfied; – make clear that the client system is being taken seriously as partners in the counseling process. The following questions may be used to evaluate the initial contact: – Did we reach the goal we set during the initial contact? (question for both counselor and clients) – How do you feel about the first session? What did you like about it? What didn’t you like about it? Was it helpful to you? What was not so fitting in your opinion? Did anything upset or anger you – did anything please you?
Background Text: Is It Possible to Observe Without Acting? On the risks and side effects of communication In the initial phase we are concerned with laying the foundation for a contract. Only then can we turn to concrete helping, intervening and taking action. Up that point we as counselors mainly absorb information and clarify the expectations of others. We cannot yet intervene until we have received a contract stipulating the extent of the mandate. But – is it even possible to observe a social system without changing it by our very actions, without effectively intervening? Is, perhaps, the question alone “What can your son do particularly well?” enough to change the atmosphere of the conversation? If we insist on getting an answer to the question and the father or mother feels pressed to describe what the son can do well and how that contributes to family life, haven’t we already exerted an influence on the system? When parents argue during the initial contact about what their son’s behavior means and the counselor interrupts the quarrel so that each of them can fully describe his or her standpoint, we are of course intervening in the system and changing the communication pattern – at least in this particular situation. This example shows that within social systems observing and acting cannot be separated from each other. Our particular way of seeing things and of absorbing the information automatically changes the system, as does our way of structuring the conversation and posing questions. Systemic work means being active. We effectively control the conversation through our questioning. Other types of assistance, on the other hand, are
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considerably less determinative and leave it more to the client to control the course of the conversation. Yet even if we were less active and less controlling, it is doubtful that we could simply observe a social system without changing it. Every form of interaction with a client or a social system occurs through communication. Paul Watzlawick (2011a, 2011b) in his pragmatic axioms on communication put it like this: “One cannot not communicate.” Even if the counselor does nothing at all, this will inevitably lead to interpretations and reactions on the part of the client. And such reactions are indeed in the very sense of the word re-actions – responses to the behavior of the counselor. Statements such as “But I didn’t do anything!” or “I meant something completely different!” may be well intentioned, but that does not change the fact that my counterparts have already interpreted the situation in their own way. And only their own interpretations determine what they will do next. Thus, their interpretations of my actions – and not my intentions – determine the course of the meeting. Another pragmatic axiom of Watzlawick was the following: “The recipient determines the content of the message.” Whether we personally think these axioms are correct or not, they clearly are valid for communication processes. They are, as Watzlawick said, “pragmatic,” i.e., they are reasonable assumptions with which we can understand and comprehend communicative processes. This leads to two conclusions: – We cannot communicate with a social system without changing that system. Observing without acting is not possible in communication. – The course of an initial contact or first conversation is dependent on both the client and the counselor. The latter conclusion serves to keep us humble: Our insights are not objective – not only because we’re the ones doing the reporting and thus report only our own interpretations, but also because the course of an initial phase or contact would have been different had some other counselor been there in our stead. The family, the group, the entire team – all of them would have exhibited different facets. We as counselors should not view the results of the initial interview as inherent properties of the client system, but as the coproduction of the client and our role as counselor. Besides humility these considerations demand something else of us: If our actions are so important to the results of the initial encounter and determine what can and cannot be achieved, then we must remain ever aware of our own behavior! How does our behavior occur? Again, we must view communication as a circular and not as a linear process. Our actions are clearly the result of our perception of the situation, which in turn is colored by our interpretation of the behavior and the input of the client system.
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But how do we arrive at our interpretations? Our interpretations deal only partially with the behavior of the client system; they are also based on our own biographical experiences and what we have made of them. Our systemic knowledge and abilities do not relieve us of the duty to reflect on our own points of view. Even systemic counselors need a measure of self-awareness! Nevertheless, we should be as interested in the many other possible interpretations of communication as possible. We should be open to and curious about other vantage points, particularly those that differ from our own. And that is not an easy task! One way to help us recognize the diversity of opinion toward communication was expounded by Schulz von Thun (1998), who describes the four sides to every opinion: 1. The content side per se: what a member of the system recounts in the initial interview (the facts, the points of view). 2. The self-disclosure side: what the speaker says about him-/herself, including revelations about pride, insults, anger, exhaustion, helplessness, beliefs. 3. Description of the relationships: whether the speaker feels superior or inferior to other members of the system, feels like a victim of the others or guilty toward them. 4. The plea side: what the speaker expects from others or from the counselor. Points 2, 3 and 4 describe information present only between the lines, which underlie the interpretation of the recipient. This model is important because we often interpret things selectively or one-sidedly – and act accordingly. We all are partial to certain sides of communication and tend to choose them as the basis for our behavior. Some of us listen mostly to the pleas (“Help me – quick!” – “Oh let’s not talk about that anymore!” – “Get me away from that man!”) and react intuitively by either taking on or refusing the mandate. Others hear only the statements about relationships (“You can’t really help me!” – “You’re too young to understand.” – “You’re so much more clever and capable than I am!”) and react with irritation, pride or withdrawal. Coming to terms with the self-disclosure side, with the pleading side and with the relationship side of statements can help us to listen better; it effectively gives us more room for interpreting our perceptions during communication with the client system. We can thus choose which of the relationship statements, which of the self-disclosure statements and which of the pleas we want to react to. Our behavior within the communication with the system automatically becomes more versatile and is no longer bound to first, intuitive interpretation. As professionals it is our responsibility to deal with our own patterns of interpretation, to question them and to develop alternatives. This provides us with choices when meeting with clients – and it keeps us from viewing our positions and experiences with a client system as something absolute and objective.
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2 Exploring, Observing, Beginning 2.5 ObservingBehaviorandInteractions
2.5 Observing Behavior and Interactions In our social and pedagogic professional life we not only interact with clients in short spurts of conversation, but often accompany them through long and important sequences of their everyday life. We are usually not dependent solely on their accounts of things, but can directly experience how they master life. This is particularly true for inpatient and semi-inpatient settings, but also in family counseling centers, family therapy institutes (see Conen, 1992) and in all forms of outpatient systemic counseling in which several members of the system are present at the same time. Particularly with clients who are more action-oriented and less verbally adept do we have to rely on our observations. Activities, nonverbal behavior or habitual behavior patterns can then be more revealing than any statement. This is sometimes true even for clients with more differentiated verbal talents. Background Text: To Interview or to Facilitate Enactment? Verbal and behavioral accentuations in system work We are dealing here with distinctions: Distinctions are known to create information and thus new insights. But distinctions can also be arbitrary differentiations drawn by an observer, delimitations that someone else might draw differently. We distinguish between systemic approaches that work primarily with conversation and those that lean more toward clients’ acting-out scenes. The list of authors we present in Table 1 is clearly based on our own subjective judgment, and of course there are many counselors who combine the two methods. Yet it is worth taking a look at the distinctions we draw: They reveal inherent differences in the way a counselor employs systemic principles (see Minuchin, 1996, p. 23 ff.). Such differentiation can help us to imagine 1. which of the approaches we prefer because it better fits us; 2. which of the methods better fits which particular setting; 3. which of the methods is best suited for which client and/or groups to ensure rapid progress. Table 1: Comparison of the various systemic approaches Interviewing
Enacting
Cybernetic, constructivistic and narrative approaches: Selvini-Palazzoli, Cecchin, Boscolo, Anderson, White, de Shazer
Structural, experience-oriented, strategic approaches: Satir, Minuchin, Whitaker, Gammer, Williams, Haley, Madanes
Stimulations from constructivism, language philosophy
Stimulations from Psychodrama, Body and Gestalt therapy
The counselor – questions the participants individually – interlinks the answers with hypotheses
leading to new questions – highly structures the encounters
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Interviewing
Enacting
Centralized communication between the questioning counselor and the answering client; the “system dance” becomes clear in the answers the system members give
Often decentralized communication, among the clients as well; the “system dance” is present only indirectly
Asking questions
Movement and staging
reveal(s) information about relationships and positions point up differences allows new perspectives as well as new ideas for solutions to arise, The significance and the inherent reasons become clear and are modified in part
Situations are experienced emotionally and new behavior is practiced
New patterns arise through the comments and prescriptions offered; behavioral changes arise in everyday interactions between the sessions based on shifts in meaning and new information within the system
New patterns arise directly through the intervention: changing the seating order, structured dialogs, sculptures, behavioral suggestions; behavior changes arise by trying out and practicing new behaviors during the sessions, through emotionally charged images and experiences
The difference between these two approaches may be seen in normal counseling situations: Case example: During a family session, the 4-year-old son begins to make a lot of noise while playing with the building blocks in the room. The parents remark that he always does that when adults are trying to have a conversation; sometimes he even becomes outright defiant. It makes a normal conversation impossible. What does the counselor do – interpret the child’s behavior as a disturbance or turn it into a subject of discussion? A more verbally oriented counselor would comment on the noise as a valuable part of family life and try to arrange a session without the child present. A more behaviorally oriented counselor is pleased to see the son so active in the family and would try to work with the theme by asking the parents to offer their son a more quiet activity and to set boundaries for his behavior. All the while, of course, the counselor observes the scene as well as the way the parents cooperate and interact with their son – and only then does he make any suggestions.
When we observe behavior we differentiate between four levels, characterized by increasing complexity and abstraction: 1. Behavioral patterns: Sven is distracted in class, playing with his cell phone or whispering with his neighbor. When called on he becomes angry. – Jessica approaches adults with great obtrusiveness. – The father is hostile and commanding toward his children. This level of observation is oriented toward the individual. We observe and describe how the person in question acts in the respective context. 2. Interactions: The teacher asks Sven to be quiet, whereupon Sven leaves the
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room in a huff. – If adults speak with Jessica in a friendly manner, she immediately goes up to them and wants to be near them and touch them. – When his children voice their wishes, the father rejects them harshly. Here we are concerned with how two or more persons interact, and we try to filter out the most typical interactions. 3. Interaction sequences: If the mother expresses her need for help, the father attacks her and accuses her of not being in control of the family. The older daughter then turns against the father, accuses him of never being at home and only causing everyone stress. He then leaves the room in anger. The behavioral patterns here are more complex: We can observe typical processes or sequences of interactions that tend to repeat themselves. We must take a step back from the concrete incidents, which are fluid, to see the repetitive background patterns behind these sequences – the grammar of interactions: the mother makes demands of the father, the father attacks her, the daughter attacks the father, the father withdraws. 4. Roles: The daughter always supports the mother in domestic conflicts. When behavioral patterns tend to repeat themselves again and again, we can consider the behavior of the individual actors to be roles that may be observed in various contexts. This approach presumes a certain amount of abstraction and combines information from our observations into a single, summary description – a social stereotype. In this example, the daughter is the mother’s “supporter.” Other examples for such stereotypes are the “attacker,” the family’s “little sunshine,” the “mediator” and many more. These examples demonstrate that behavioral patterns are always part of interactions and cannot exist independent of the context. Systemic descriptions thus usually refer to the second to fourth level mentioned above. But it is worth trying, just for practice, to describe client behavior. We then better understand the small differences that occur when describing, classifying, interpreting or evaluating our own perceptions and formulations. Is it: the father rejects the children’s wishes and speaks loudly and in a commanding tone with them? Or: the father acts like a dictator and is hostile toward his children? Or: the father is overwhelmed by the large family and reacts with improper authoritarian behavior?
2.5.1 Behavioral Patterns In reports we often find statements that are a mixture of descriptions, interpretations and evaluations; or the behavior of some actors is described as character attributes. Both methods, however, contradict the systemic approach: The behavior, observer and social contexts must be viewed individually and separately. More importantly, such methods do not really help us to develop ways to solve and change the situation. The danger lies in reinforcing the status quo and turning changeable behavior into long-term attributes. The verbal implications are clear. We tend to speak about how a person “is” and not how that person “behaves”:
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“Sven is inattentive” is a classification; “Sven is distracted in class, playing with his cell phone or whispering with his neighbor.” “When called on he becomes angry” describes his behavior in context. Good and precise descriptions of behavior form the basis for an in-depth analysis of the problem and the resources available to a person. For example, they may point to developmental deficits when we have observed motor impairments that call for expert assistance. The systemic counselor does not describe the deficits or disorders found in a particular context, but rather pays attention to the skills, strengths and resources of individuals (cf. Durrant, 1993). This in turn has a great effect on the way clients see themselves, the client-helper relationship and the planned intervention: Case example: Sabine is very obliging during group activities. Michael can share with others and, despite his aggressive tendencies, is very accepted by others.
Further, the skills buried in problematic behaviors can be described: Case example: By disrupting class David reveals his pronounced creativity and his ability to master funny situations. Beate, on the one hand, tells lies and must attend to this matter, though on the other hand her stories are very ingenious and full of details.
Sometimes it is helpful to take a look at the way other schools of thought approach these matters. Scenic Comprehension The term scenic comprehension (Lorenzer, 1983) is widely used in psychoanalytic circles. The counselor observes the client’s behavior patterns and applies this knowledge in order to better understand the unconscious patterns and themes that lie behind them. Case example: The single mother almost always arrives late – for nearly everything: picking up her child from the special needs nursery school, meetings at Child Welfare Services and conferences with caretakers. She always has plausible explanations, of course, which in light of her raising three children are generally then accepted. But it remains a persistent pattern. The helpers interpret her behavior as resistance against their care, which was set up on the initiative of the school and was initially rejected by the mother. In a meeting, her behavior is simultaneously treated as a disturbance, addressed both morally and pedagogically (“You know, you should have . . ., your child is waiting . . ., this mustn’t continue . . .”), and as a way to understand what is going on with her. It quickly becomes clear that her explanations are often just excuses; she explains that she has so much going on that if she gets behind, she has to rush to the next appointment in her schedule and nearly always arrives too late. She is effectively staging her own opposition to the many demands being made of her. These demands of her as a single mother are, indeed, heavy and force her to push back her own desires for more space and freedom – for simple downtime to enjoy her own impulses. In the end, the nonjudgmental conversation defuses the theory of her staging resistance and lets those involved understand and appreciate her true desires. The meeting
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results in the resolution that the mother should get some space and time to attend to her own needs.
Behavioral Patterns in Behavioral Therapy Behavioral therapy attacks problems by probing and observing: What is the client reacting to with the specific behavioral patterns? System therapists can profit from the amazing precision with which behaviorists describe behavioral relationships. Observing behavior in vivo often leads to more revealing insights than just simply listening to someone talk. Case example: Mr. P., a truck driver, describes the fact that he tends to avoid driving on the interstate because of a diffuse fear and the stress reactions it causes in him. Conversations about this matter have yielded little concrete information; Mr. P. has no real explanation for his behavior, and he is not accustomed to observing himself and his actions and deciphering possible reasons. But an in-vivo-session in the front seat of his truck during a long trip did bring some revelations: Mr. P.’s particular problem lies in making split-second decisions in high-volume traffic. He hesitates and tends to overtax himself for the benefit of others. But of course the norm is that such situations occur again and again when driving on the interstate: on the ramp, when passing another truck, when changing lanes. If you always wait for a big gap and only then have the nerve to pull over, then it will be a long trip, or one full of stress both for oneself and for others. That is why we experience a number of situations during the trip in which Mr. P. waits to enter traffic with a long line of honking drivers behind him. This behavioral pattern also manifests itself in other social situations where self-assertion is necessary or where his own behavior becomes a burden to others. In family sessions and in a group context he learns to be more forceful. As far as we can see, he now also drives more resolutely – and more relaxedly – on the interstate without overdoing it: In any case, he has yet to cause an accident!
From cognitive behavioral therapy (more precisely, from the rational-emotive therapy proposed by Albert Ellis, 2004) we can adopt an instrument for our own purTable 2: The ABC analysis of the case example of Mr. P., the truck driver A Activating situation
Mr. P. approaches, or is in the middle of, a situation that requires him to expect something of other people, for example, to slow down or brake for him. – In a restaurant Mr. P. would like to order a drink but sees that the waitress is very busy, so he goes without and leaves the place thirsty. – At home, when he is tired, he doesn’t demand that his daughter complete more household chores.
B Belief system
Mr. P. is very respectful toward his fellow human beings, demands little of them and spares them a lot (which is not all bad). He is convinced that he is not worth enough to demand anything from others. He sees his role in life as just standing back.
C Consequences
When Mr. P. is in an activating situation, he feels stressed and freezes up, reacting with anxiety and somatic symptoms (trembling, lump in his throat) – or he withdraws completely and suppresses all of his own needs.
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poses, which is both simple and profound and quickly accepted by many clients: the ABC analysis. The classic stimulus-response model introduces a third, cognitive component: B for belief system – for one’s convictions and values (Table 2). This simple scheme can be used when planning interventions: self-instructions and convictions can be tested and modified (B), alternative behavior discussed and practiced (C). At the same time, one can determine which behavior is appropriate to which situations and when it is worth adhering to (A).
2.5.2 Interactions: The Social Dynamics of a System In social systems, be they families, groups of children or adolescents, teams or organizations, participants interact intensely (and sometimes very volatilely) with one another – something an outsider can then observe. Background Text: What Are Interactions? During interactions we take reference to others by means of behavior; we exchange information with others and we mutually influence each other. Social systems arise through interactions (Luhmann, 2009). By social interaction we mean speech and behavior – we act (from the Latin agere). Observing interaction thus also means observing the nonverbal signals humans exchange. Hence, systemic diagnostics is always a matter of interaction diagnostics (see Cierpka, 2003, p. 23; Ritscher, 2012, pp. 36 ff.), regardless of whether we have initiated the interaction by inviting the participants to talk to us via our circular questioning, or whether we are observing the interaction directly; regardless of whether we are dealing with a spontaneous interaction or one instigated by our intervention. But what advantage does this perspective offer for our work? The exact observation and description of interactions tells us something about how the family or group in question is structured, and from this information we can build hypotheses for our work. By observing the changes that occur in interactions, we receive better feedback concerning changes to the system than we would have gotten from narrations alone. Narrations tend to be repetitions of the “official” versions of events, whereas behavior usually cannot be cognitively controlled as easily as language.
Here are a few examples of how we can observe interactions – even in the very first few minutes – and how they, already, can become part of our hypothesisbuilding process. But beware: The more we structure things by asking questions or by direct intervention, the less we get to observe spontaneous behavior. If we cause everyone to speak at the same time, we will not be able to see who is being heard and who is being ignored.
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– The counselor should register, during the greeting phase, who greets whom and how – and how parents react when their teenager goes by without even a glance. – The counselor should observe the seating order and how it came to be: Did the parents or the children guide things? And who sat next to whom? – If the father begins with a long monolog, listen carefully to the content while remembering that it is the Alpha male who is speaking. – If you ask the mother for her opinion, observe whether she says something different than the father or whether she effectively yields to him. – Ask the parents to pick one of several matters that are important to them and then observe whether they can reach an agreement or whether the children intervene. – During the conversation note who speaks when and with whom, who faces (or ignores) whom, who is listened to and who is ignored.
During socioeducational family interventions one can put the focus on slightly different matters: – How is the situation structured (where does the meeting take place, how clean and tidy is the place, is something offered to drink or eat)? – Are limits set (neighbor comes by, children jump around and over the furniture, dog runs around everywhere, baby cries)? Such observations can greatly help to focus the attention during the intervention.
2.5.3 The Group as a System: Interaction as the Key to Social Dynamics In groups and teams, too, precise observation can reveal existing relationships and the changes that occur following intervention. But once again: The more we strive to structure things, the less spontaneous interactions will be we end up observing. This means that, besides infusing structure, the counselor should also leave room for spontaneous behavior: questions, small tasks, requests for quiet, appeals for consensus, exchange of arguments – all of these are also invitations to act and to present information.2 In our work with groups of children and adolescents, in particular, we are dependent on observing interactions. Using questions and sculptures to understand the social dynamics is of limited benefit. Most readers are aware of and have experienced the situation that children and youths in groups (or families) react to questions concerning relationships, interactions, etc., with disinterest or even displeasure: – With children up to adolescence, language is usually not the preferred medium to present how they deal with reality. They are more adept and amenable to 2 In Section 3.5 we show in more detail how these observations can be structured and documented in a sociogram. And later, in Chapter 4, we are concerned with how to build hypotheses for working with groups.
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games, acting out, painting and other physical activities to express and work through their thoughts. Sometimes, however, one nevertheless chooses to intervene verbally with children, particularly if they are in need of instruction on how to develop such skills and how to use them to find solutions. – Children generally tend to avoid dealing with conflicts and troubles. They approach such matters by developing exciting fantasies or games to compensate or to simply distract themselves. Up to the age of 8, make-believe (symbolic) play is the main type of play and is then slowly replaced by games with rules. How much one actually gains by dealing directly with difficult matters in order to solve problems is usually clear, at least cognitively, to adults in helper roles; this is the basis for our interviews and interventions. But children do not always accept this method. Fryszer (1995) diagrammed how, in therapy, children deal with even the most difficult circumstances and experiences without directly addressing their suffering. Thus, we need to exhibit great sensitivity and care when using verbal interventions in children. When a teacher speaks directly with children about conflicts or social situations in the class, she is attempting to get the children to reflect on social relationships in very adult ways. This method may sometimes be an important stimulus for child development, but it may also prove to be inadequate for children in this age range. When working with children and youths we are, in fact, often limited to observation and nonverbal interventions. Collecting observations in a group of residential youths: – How do the individuals in the group act toward each other and toward others? – Who is closest to whom? Who avoids whom? Who speaks up? Who interrupts whom? – Is there a person or persons with whom contact is often sought? – Is the activity equally distributed or do some individuals talk more and others less? – How does the group deal with mistakes and weaknesses? – What themes, activities, games or interests help to make contact? – What themes, activities, games or interests create subgroups? Collecting observations in children’s groups in an institution, school or nursery school: – Which child likes to play with which other child? What does the group do as a group? – Which child is excluded? Which child is overlooked? – Which children form subgroups? – What themes, activities, games or interests create subgroups? Which of the subgroups become rivals or pursue contrary interests? – Which children are able to form dyads with another child? What themes, activities, games or interests connect these dyads? – Which choices are made unilaterally? Which choices are met with rejection?
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An observer with a schooled and trained eye (and sometimes ear or nose) can obtain many profound insights and a deep understanding of what is going on in the group. Of even greater interest, albeit more complex in nature, is when we are dealing with sequences of behavior and interaction.
2.5.4 Behavioral and Interaction Sequences When we observe that typical series or sequences of interactions always occur in the same manner within a system, a family, a team or a group, we can begin to form hypotheses about the organization and structure of that system: The content may change, but the basic patterns of the sequences (the so-called “grammar of interactions”) remain the same. Minuchin (2012) has coined the term transactional patterns. He is a proponent of families being encouraged to have concrete interactions and work directly with the results: “In general, instead of letting people talk about past events. Rather, I tend to give situations immediacy by bringing them right into the session. For instance, if I am working with an anorectic patient, I eat with the family. If spouses talk about a conflict, I ask them to enact it” (Minuchin, 2012, p. 93 f.). Here, we can differentiate between redundant and escalating interaction sequences. Redundant Interaction Sequences Case example: Whenever a mother expresses her need for support, the father attacks her and accuses her of not being in control of the family; the older daughter then turns against the father, accuses him of never being at home and only causing everyone stress. He then leaves the room in anger.
This interaction may be observed in families in many different variations. The reasons may change, but the type of disagreement doesn’t: a ritual the family has (unconsciously) come to agree upon. This we call “redundant interaction sequence.” If the dissocial behavior of the daughter is the problem in the sequence presented above, then from the redundant pattern we can conclude that the daughter has used the parents’ conflict to ally herself with the mother in order to weaken the subsystem “parents” and avoid sanctions. This hypothesis is formulated on the assumption that the daughter has initiated the quarrel and is responsible for the intractable situation. Yet this would not correspond to a systemic view. The mother (who needs support in her fight with the father) or the father (who displays an inadequate reaction, in part overly aggressive, in part huffy as to weld the mother and daughter together) could equally form the crux of the hypothesis.3 Systemic observation does not look solely at the systemic function of any one 3 Sometimes it is a good exercise to formulate new hypotheses by alternating the persons involved as the initiator of the sequence.
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behavior, but rather at the behavioral bandwidth the individual members have at their disposal. Such interaction sequences may be maintained solely through a lack of knowledge or the incapability of the actors present. Case example: Did the father learn other behavioral patterns as reactions to the demands and needs of his wife? Is it hard or easy for the mother to set boundaries for the daughter because she herself had no model of good parenting in her own family? Do the parents have any experiences, ideas or models of how they can cooperate as parents to help their daughter during the difficult phase of puberty?
This is the first level of behavioral patterns, and from our experience in our work with so-called marginalized groups we believe that the elements of leading, stabilizing, teaching and coaching have a definitive place in systemic thought and are particularly helpful and effective in that context (see below in Chapter 6.2). Escalating Interaction Sequences Bateson (2000) differentiates between symmetric and complementary escalation in systems. In symmetric escalations the actors act similarly, reacting to each other in a circular pattern with ever the same behavior: The more one person does of one particular thing, the more another person does of another. An arms race, much like that found between sovereignties – a typical symmetric escalation: Case example: The more the husband yells, the more his wife yells back at him. The same is true for withdrawal. Or: the more the wife brags, the more her husband boasts about his successes. Mutual goading ensues.
In complementary escalations, the participants act differently, though they nevertheless mutually reinforce their behavior patterns: Case example: The more the husband clings, the more his wife withdraws; so he clings even more, and she withdraws even more. The sloppier the son is, the more his mother assumes responsibility for him and takes care of him; the sloppier he gets, the more she takes care of him.
Maria Aarts (2009, p. 107) very impressively describes such an escalating convolution in parents with so-called cry-babies: – The child cries often and long, never quiets down. – The parents are tired, reacting gruffly toward the child, or they become hectic, helpless, rude. Their inflection and nonverbal signals point toward high tension. – The child now shows his or her malaise even more clearly. – The parents (over)react with total attention, attending to the child simultaneously. – Now the child has even less opportunity to quiet down. Symmetric and complementary escalations are similar in that the interactions always escalate, being mutually reinforced, and the situation inevitably comes to a boil. There is much to be gained from analyzing such interaction sequences. Often we are dealing with circular communication loops the participants are unaware of. In complementary escalations, especially, a hint by the counselor about the nature of the situation can be very enlightening: The participants tend to see things only from their personal vantage point, which leads to an endless series of mutual accusations.
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Case example: The mother in the example given above says: “My son is so irresponsible. I have to take care of everything myself, otherwise it ends in a catastrophe.” To which the son replies: “There’s no use in my becoming active, my mother will always butt in with something to say. She always knows better, bosses me around, and if I want to do something myself, she’s already done it!”
Helpers, too, are in danger of personalizing everything: If the circular process has been going on for a while, the actors inevitably become self-caricatures. They show only limited parts of their personalities and seem to have forgotten the rest. This makes them vulnerable to stereotypical diagnoses, as the following case example shows. Case example: The son who at one time may have been a little lazy now appears to be completely irresponsible – a freeloader who just won’t grow up. In other situations, however, he can very well assume responsibility and act goal-oriented. The mother, who originally was just very concerned about her son, is now an overprotective übermother who cannot let go of her 35-year-old son – though in other situations she can draw boundaries and demand more of others.
2.5.5 Roles When typical behavioral sequences occur again and again, we can describe such behavior as a definitive role that is always observed in the specific context. Roles may be seen as the distillation of repeated interaction sequences. If these interaction sequences occur in the same way with a high predictability, then expectations occur: The parties come to expect that the others will always act that way. Case example: When the parents fight, the daughter regularly takes the role of her mother’s supporter. The father takes the role of the aggressive screamer who always backs down when things get too rough for him. The mother has the role of the helpless demander.
Cave: Roles cannot be observed. They can only be assumed from watching behavior, but they always remain constructs. How do roles arise? Here a short story to elucidate the question: Case example: A group of trainees meets for several days every 6 weeks. On the next to last day, one member (let’s call him Jan) saw to it that enough taxis were ordered the next day for all participants. He writes on the flip board the names of everyone who needs to go to the train station, to the airport, etc. Then he calls and orders the taxis. No problem. The second time they meet, Jan repeats this action and, again, everything works out fine. The third time the group meets, however, Jan does nothing. At dinner the night before the conversation turns to him: “But Jan didn’t . . .,” “It’s going to be very close now . . .” The next morning he is scolded: “Why didn’t you . . .” Surprised, he replies that it was not his duty and he simply didn’t want to order taxis, and maybe someone else could take care of it. This causes great irritation: “You can’t just stop doing your job and walk away from it!” Other group members become engaged in the conversation, and the whole thing eventually reaches absurdity, so that in the end only humor can help in the analysis of what happened.
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Jan’s role resulted from the interplay of supply and demand or, in other words: One person offers his surroundings a part of his skills and resources, and they accept what they can use (organizational talent and willingness to help). When this interaction repeatedly succeeds (in our example twice), a role is established. Everyone grows accustomed to this course, since indeed they need what is offered, and soon they begin to expect that it will always be that way in the future. Behavioral expectations toward the role-player arise, with the danger of sanctions if that person fails to correspond to the expectations (anger, withdrawal). Strong, fixed roles, in turn, reinforce certain behavioral tendencies in that person, which then remain in the foreground. And these tendencies negate other, weaker tendencies wither away or are forgotten completely. Below, we would like to demonstrate this scheme with an example taken from the role of children in families. Our first and foremost learning field about behaviors and roles is the family in which we grew up ourselves, whose models we transfer to other contexts. If in our own family we had the part of, say, the arbiter, then we may end up in a helping profession and train to be a mediator: Basic training took place in the boot camp called family. The roles in the family develop for various reasons: – According to the child’s disposition. – According to needs, i.e., which roles are necessary within the family. A depressive family, for example, may need someone to lighten things up; an uncertain family needs a brainiac to be proud of. Stierlin (1982, 1992) describes such mechanisms as forms of delegation – the assignment of unconscious wishes to one’s children to live out. – According to the roles available in the system. – According to the chances for success, i.e., that the choice of a particular role will reap attention, devotion and appreciation. We are constantly assuming roles; we live in a world of expectations and we adapt our behavior to the necessities and successes we experience. A healthy upbringing is favored if the roles among the children in a household change once in a while depending on the situation (at home, with relatives, on a sports team) or change over time to fit our age and development. This ensures a broad range of experiences – and the ability to better cope with life. Dysfunctional development arises when children are pressed into fixed and rigid roles and bound to a certain behavioral spectrum. This lopsidedness can encumber a child’s behavioral range since complementary qualities can no longer be experienced and integrated. Table 3 shows a few of the roles children play in the family. Also, besides naming the role itself, the table describes the basic characteristic of the respective role and the possible contribution it offers to family life. The table also lists the complementary, hidden behavioral repertoire which children in that particular role cannot or rarely show.
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Table 3: Roles in the family Role
Characteristic
Possible contribution to the family system
Hidden quality
Little sunshine
Friendly
Easily makes contact and is good-humored
Anger, withdrawal
Poster child
Competent
Makes you proud, satisfies parents’ own need for selfesteem
Misbehavior, hedonism
Clown
Funny
Cheers up, deflects sadness
Seriousness, sadness
Precocious
Responsible
Supports parents
Shows weaknesses, needs, being childish
Problem child
Problematic, ill
Diverts from other things, unites parents in their concern
Happy-go-lucky life
Fidgeter, troublemaker
Burdensome
Diverts from other things, Peace and quiet unites parents in disciplining
Black sheep, scapegoat
Lives out the hidden desires of the family
Unites the family in their re- Getting respect jection, assume all negative projections, exonerates the siblings
Mediator, peace- Even-tempered maker
Resolves conflicts, ensures harmony and reconciliation
Feeling and asserting own needs and opinions 2.6 Ob servingOne’sOwnPhysicalandEmotion alReactions
2.6 Observing One’s Own Physical and Emotional Reactions When we meet with clients we are often touched by the things they say; their stories can really get under our skin – some we find sickening, others give us goose bumps or warm our hearts. Our language is full of sayings that reveal how involved our entire body can become in such situations. This is true even for counselors who try very hard to remain neutral: We are irritated, happy, bored, distracted. Sometimes, after a good meal, when our eyelids are only half open (and we wonder whether the clients are noticing), or when our attention wanders – suddenly we are wide awake at what is being recounted. Are such circumstances only minor disturbances that any professional counselor and therapist must have under control? Or can we somehow use them for our work? Emotional reactions (anger, sadness, happiness), physical reactions (fatigue, tension, disquiet) and cognitive reactions (images, thoughts, memories) reflect what has happened and are thus important sources of information. Learning to understand and to use these various types of reactions is part of systemic work. That, however, requires a large measure of self-awareness. And because we know that our perceptions are not just reflections, but also active constructions on our
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part, our own stake becomes even more important. All of which seems to suggest that one should be careful and allow only very distanced and impersonal cognitive components to be employed in one’s therapeutic and counseling work. Yet our experiences speak a different story: Human beings perceive things holistically, and it is our conviction that a conscious exclusion of these inner processes would negatively affect our work. Important channels of information would lie dormant. Or, put more radically: Our inner reactions will happen no matter what – there is no avoiding them, whether we consciously introduce them into our plans or not. We could, as psychoanalytic theory would suggest, even postulate that the denial of these inner processes would carry with it the danger of our introducing them in an unreflected manner into our otherwise rational actions. Case example: When I am particularly irritated at a client but think this is an unprofessional reaction and thus try to regain my rational composure, I may actually increase the probability that I will insert at least some of my anger into the encounter. Alternatively, I could simply accept my feelings and ask: What is making me angry? Do my feelings have more to do with me and my hectic day in my own family or am I ignoring some important things in the client system that need to be put on the table?
Using these reactions carefully and professionally assumes that one can differentiate between the two – and not mix up one’s own experiences and reaction patterns with those of the clients (projections). As a counselor I must know what I am reacting to, what has its origin within me, my own familial traditions and my present situation in life. Of course, one cannot be 100% sure of properly assigning such an experience; yet, the more consciously I deal with my own reaction tendencies, the better I can use my own feelings and impulses in any particular situation as a valuable source of information. Case example: In a supervision group with juvenile court counselors the topic is one particular youth who is causing one of the members a great deal of consternation because of his very aggressive behavior. The group is exploring the background and context of the situation in order to better understand his behavior and perhaps to gain some insight into his actions. One colleague, however, remains very quiet. When asked what he is thinking and what is going on inside him, he answers that he just isn’t in a good mood today and can’t concentrate, a private matter. When asked again he says a song has been spooking around in his head the whole time, which he attributes to his bad mood. The supervisor becomes curious about this and asks him what song it is: “I’m so lonely” by The Police, a song with a relatively aggressive rhythm. He apologizes again for not being very attentive. The colleague who brought up the problematic youth reacts immediately and asks whether that might be a key for the young man in question, whether his behavior might be the result of his loneliness, that his behavior reflects his need for contact with others in order to discharge his built-up anger at his unfulfilled needs. The group now pursues this line of thought, which proves very fertile for understanding the client and planning further interventions. The concerned colleague decided to focus on the concept of “contact” and was largely successful.
Colleagues who have a background in hypnosis are well aware of such processes, since their therapeutic concepts put great emphasis on unconscious patterns of
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reaction and communication (see Schmidt, 2010, pp. 198 ff.). The same is true for the concept of “countertransference” in psychoanalysis: – Feelings and reactions can be indications of unexpressed themes: A sudden flow of sadness can be a harbinger of an important matter or simply point out that the client does not wish to address this theme directly. – Feelings can reflect process dynamics: Fatigue can indicate that no one present truly wants to work on the matter at hand; energy dissipates, the conversation falters. Carl Whitaker cleverly showed at congresses both in live demonstrations and on video how to address these processes head-on and how to use the dynamics initiated in this manner. – Feelings can describe relationship and behavioral patterns: Anger at the behavior of a client may reflect that person’s provocative and disrespectful manner of dealing with relationships. – Inner reactions can correspond to the attitudes of the client: A sudden feeling of inner tension may mean one is now approaching a difficult and fear-ridden topic. Achieving competence in counseling and therapy by perceiving and employing one’s own somatic and emotional reactions is difficult to do by reading a book. Guided experience is the best route, so we will leave it at that.
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During the exploration phase the counselor is confronted with a large amount of information. Human systems are complex, and keeping track of who’s who and of everyone’s function can be difficult. Every actor in a system has some connection with every other actor, and depending on the perspective that relationship may take on a different hue. Remember that every system consists of many stories within a grand story. Clearly, the limit to our intake capacity is quickly reached. Evaluating and documenting this flood of information plays a major role because of the very complexity of social systems. The goal is to reduce the complexity and make it manageable. We need simple techniques that provide a quick overview – a bird’s-eye view at the system and its particular history. This enables us to identify the most important structures and later use this knowledge to make proper decisions. If we don’t have sufficient distance to our information or the situation, we will inevitably fail to see the proverbial forest for the trees. Long descriptions or reports of the sessions are time-consuming and of little value for extracting the necessary information: Recipients of such reports have great difficulty filtering out the essential from the unessential information. In this volume we have assembled a number of methods and tools for organizing, documenting and analyzing information about social systems, which have proved themselves in the past. These graphics help to condense information and provide that bird’s-eye view of the basic structures. This prepares us for the next step, namely, developing hypotheses. In daily practice there is another advantage to this method: What we learn in the sessions we can also pass on to others; colleagues can learn from our information. This saves clients repeated exploration, too. A supervision or case-study group can easily and quickly orient themselves to the client and helper system, without having to know all the (sometimes confusing) details. Case example: In a large center for youth welfare services, following a number of general training courses in systemic counseling for the colleagues employed there, we began to create guidelines on how to carry out and document explorations, initial phases and initial interviews. This simplified their work considerably and helped to better structure it. Above all, moving clients from one house team to another no longer meant that the new team had to start from scratch. The coordinated approach to exploration and documentation also led to a common technical vocabulary.
In the following we present tools such as the genogram (Chapter 3.1), the map (Chapter 3.2), later united in the family-helper map (Chapter 3.3). This will help us to better sketch the affiliation and social dynamics of the system. A timeline
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(Chapter 3.4) orders the system’s history and anamnesis. The final sections of this chapter are devoted to suggestions for preparing reports. 3.1 TheGenogram
3.1 The Genogram The genogram is a graphic representation of the relationships within the family. Today, it is a widely used, traditional tool for displaying the structure of a family (see the family tree). The symbols used are similar across all depictions and provide quick and easy orientation even in genograms with slightly different schemes. We adhere to the depictions suggested by McGoldrick and Gerson (1986, Figure 3).
3.1.1 Notes on Constructing a Genogram – The solid lines between the person symbols are arranged so that biological parents, biological children, marriages, divorces and separations are clearly identifiable. – The various generations in a family are arranged from top to bottom so that one can immediately see who belongs to the generation of grandparents, parents and children. – Encircling persons with a broken line (sometimes with another color) shows who is presently living with whom. – In client systems we recommend including only a selection of aunts and uncles from the parent generation as well as grandparents in order to reduce the complexity. The criterion should be: Who is relevant to the planned intervention? Otherwise, the genogram may suffer in clarity and usefulness. The situation is different, however, when reconstructing a family or determining the relationship of a client to his or her original family. In such cases, all known family members should be included. – In addition to the symbols suggested, we recommend noting the names and first names as well as the age, dates of birth and dates of death of all persons. – In client systems add such details as symptoms, illnesses, peculiarities, cause of death, special handicaps, etc., to the persons’ names. For this reason, too, it may be advisable to limit the number of persons depicted in any one genogram. – It may be best to draw up a genogram directly together with the persons involved. Clients often consider this engaging because it offers them too an orderly overview of their own family. For this purpose use a big-enough piece of paper (flipchart size, portrait or landscape mode).
Sometimes, however, it is not easy to draw up a genogram together with the client since modern families often consist of many patchwork elements of siblings, stepsiblings, half-siblings, adopted and biological children. In such cases the following has proved advantageous:
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Figure 3: Symbols for creating genograms
– Start off with the child level (at the bottom of the sheet). Order the children from left to right according to decreasing age, putting those first who presently belong to the family system. Paternal half-siblings of these children can then be entered on the left in the same way, maternal half-siblings on the right. – Then connect, as described above, those children who have the same father and the same mother and connect these subsystems of siblings to their respective sets of parents.
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– Now, present and past partnerships can be entered on the parent level; encircle with a dashed line those partners presently living together. – Now add the grandparent generation and the parents’ siblings (aunts and uncles) – inasmuch as they are relevant to the problem at hand. – Finally, note any special information such as symptoms, illnesses, peculiarities, etc.
The counselor should gather ideas together with the clients on how to make the connections between the various constellations and problems.
3.1.2 Genograms: Two Examples In the following we present two examples of what genograms look like and how they can be practically integrated into systemic counseling. Case example: Paul, 14 years old, goes to secondary school. His grades are poor, he often forgets to do his homework, sometimes he skips school altogether, hangs around with his no-good friends. The exploration reveals the following: – Paul’s father has his own business. He too was a poor pupil at school and to this day doesn’t think much of education. In fact, he respects his son’s attitude toward the school and has a certain amount of sympathy for his son’s friends, who remind him of his own acquaintances at that age. Despite his own problems with reading and writing, he was able to become a good craftsman. He enjoys spending time with his employees at the building sites and tends to hang around there longer than necessary. – Paul’s mother is head secretary at a midsized company. She was always good in school and still believes in getting a good education and vocational training. She likes to go to the theater. In her family everyone except her has a college degree. – The parents disagree on a lot of things, including how to judge Paul’s situation in school. The father thinks it’s not all that bad, but the mother is worried about him. They also have very different interests and hobbies, which causes problems in the family. – In recent years Paul has tended to lean toward his father’s position.
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Figure 4: An example of a genogram of a client family
3.1 The Genogram
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Figure 5: Example of a genogram using the Freud family (from McGoldrick & Gerson, 1986, p. 19; for an explanation of the symbols see the Background Text on “Contextualization”)
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Background Text: Contextualization What is so systemic about drawing up a genogram? A psychoanalyst working as a counselor could just as well draft a genogram to get a better look at a confusing family system. The most important thing about working systemically is not the gathering of information about family relations and the subsequent creation of a genogram. This act becomes systemic only when one uses the genogram to contextualize the disorder. Such contextualization of disorders, symptoms or problems is the core element of the systemic method and contrasts sharply with other approaches that emphasize the individual. But what does the term mean? Let us take a look at the difference between the person-centered approach and contextualization using the two genograms depicted in Figures 4 and 5. First, Paul’s client family: In the person-centered approach one would trace the problems back to Paul’s personality. Paul is lazy, stubborn, unmotivated, aggressive. Depending on the theoretical orientation, these traits would be seen to result either from his biographical or his genetic background. In this approach the problem always originates from the individual. Therapy means offering Paul an individual plan to help him to change his personality traits. This could mean supporting him in school or providing intensive individual counseling or complete psychotherapy. Contextualization, on the other hand, means looking at the problems against the background of the familial and nonfamilial relationships. According to this approach, Paul’s behavior, seen within the dynamics of his family and his complete environment, makes sense. This view also points out the influence Paul’s school problems have on the dynamics of his parents’ marriage. His orientation toward his father and the father’s clandestine sympathy with Paul’s attitude toward school may end up reinforcing Paul’s school behavior. Paul’s behavior may be the way males in that family express their identity. And his school problems could serve to strengthen the dynamics of his parents’ relationship. The problems may be centered on Paul’s leanings toward the one or other parent in the conflicts between the parents, reflected in the differences between the mother’s middle-class, educated family and the father’s blue-collar background. To contextualize the disorder means seeing Paul’s behavior as making sense in the context of his family and his surroundings. In this sense the systemic approach to working with the parents or the entire family would be an alternative to initiating individual therapy with Paul. One could talk about the different traditions in the parents’ families concerning education and training. One could see how the new family approaches this matter, how well the parents can agree on a single stance toward education, how they deal with the conflicts that arise in childrearing because of their different background or value systems.
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The goal of systemic therapy is always to see the problem not as the result of characteristics found within an individual, but to view that person’s history in situ – to observe the relationship structures and conditions. Even then the cause-effect relationship can be viewed linearly: Because the parents have a hidden conflict, Paul has a problem. Thus, the context of the problem is seen as its cause. In early systemic approaches this was the norm. But contextualization can also introduce the circular perspective, which factors in the effect the problem has on the context: Paul’s behavior in school both stabilizes and exacerbates the parents’ conflict. This highlights the reciprocal stabilization effect the system and the symptom have. On the genogram of the Freud family shown in Figure 5, von Schlippe and Schweitzer (2007, p. 132) write the following: “An interesting example: Sigmund Freud suddenly developed migraines at the age of 40, which caused a burdensome interruption of his work (he could no longer write or publish). The genogram . . . reveals a number of hypotheses about this event: Is he stressed by his many children? Does the recent addition of his sister-in-law to the household represent a temptation to him, the rational, self-controlled man of the house? Perhaps the situation is like the one in his own family: His father’s second wife was considerably younger than her husband – in fact, she was just as old as his sons from his first marriage. Or perhaps Freud felt pushed aside in the family since his wife’s sister had moved in, since the two being were very close. Did he withdraw to nurture his migraines for this reason? In his own family he was the oldest in a long list of siblings: Was the responsibility too much for him to shoulder? And finally: His father had died that very year – what did his death mean to Freud, the eldest son who had been so extremely oriented toward his father?”
In this example the authors clearly show how a genogram can be used to contextualize a problem, in this case Sigmund Freud’s writer’s block. We could add to the above-mentioned hypotheses others that reflect the repercussions of Freud’s work problems and his migraines on the familial context, thus utilizing both contextualization and linear components. If we were dealing here with a behavior in need of treatment, then viewed in a person-centered environment we would make very different assumptions that would reflect only the personality of Sigmund Freud (say, a reactive depressive episode with somatization). Consequently we would consider offering him individual therapy – of course, what else but psychoanalysis! Because contextualization is such a central tenet of systemic thought, we will come back to it repeatedly when looking at other tools that can be applied in this sense, too.
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3.2 Map
3.2 Map This type of graphic depiction of observations made in a family stems from Salvador Minuchin (1967, Figure 6). Minuchin used various symbols to draw up a family map to provide information about the relationship structures in the respective family. But – a map is not the same as the landscape. The map summarizes and distills information, allowing for quick orientation. But it provides only the observer’s subjective point of view! It is an interpretation of reality, a snapshot, so that further information and developments would necessarily lead to change in the map!
Figure 6: Symbols for a map according to Minuchin
3.2.1 Functional and Dysfunctional Relationship Structures According to Minuchin Before we take a closer look at this tool, let us first consider its conceptual background. Minuchin’s approach is considered a structural approach.
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Background Text: What Is a Structural Approach? Steve de Shazer offers a good explanation: “According to structuralist thought, the meaning of a sign, a word or any other behavior can be known through its signifier or its deep structure. (Minuchin’s ‘structural family therapy’ is but one member of a much larger class known as ‘structuralism.’) Structuralism, a movement for determining and analyzing the basic, relatively stable structural elements of a system, especially in the behavioral sciences. ‘The structuralists, in general, are concerned to know the (human) world – to uncover it through detailed observational analysis and to map it out under extended explicatory grids. Their stance is still the traditional scientific stance of Objectivity, their goal the traditional scientific goal of Truth’ (Harland, 1987, p. 2). Traditional forms of psychotherapy, including brief psychodynamic therapy and most family therapy, are based on structural thought, on what seems to be a commonsense point of view about problem-solving: Before a problem can be solved or an illness or disease cured, it is necessary to find out what is wrong, to make a diagnosis. That is, they share the structuralist assumption that a rigorous analysis of the problem leads to understanding it and its underlying causation or disease; what the client presents or complains about is ordinarily seen as just a symptom of something else” (de Shazer, 1980, p. 30). Consequently, there are two basic assumptions common to Munichin’s approach and all other structural approaches: – Behind all observations and descriptions there lies an identifiable structure. To that end, however, we need descriptions that are independent of the observers. This assumption runs counter to the constructivist approach we introduced above in Chapter 2.2 in the Background Text concerning systemic thought. – An analysis of the system is both meaningful and necessary in order to recognize the workings and particularly the dysfunctional parts of the system and to excise the symptoms. This assumption runs counter to the solution-oriented narrative approaches such as that of Steve de Shazer. We should keep these basic assumptions of Minuchin’s theory as well as their contrast to other approaches in mind when we look at the range of different approaches (shish kebab vs. goulash method of counseling!); we can learn a lot from Minuchin that will help us in our work with systems. Yet we need not assume that there is indeed such a structure, though it is helpful to combine information into structural hypotheses. In our practice we have learned that some relationship structures are indeed helpful and others not very helpful for families, parents and children. It is worth remembering this even if we don’t make it our only guiding principle for all clients. Besides the now popular tendency to be critical of Minuchin’s structural approach, there is another aspect that should enter into the picture: Minuchin
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worked in the United States and was focused on clients from lower SES who often lived in slums (Minuchin, 1967, 2006). Above all he was concerned with structurally weak, fragmented systems, which made him believe that any element that strengthened structures would supply the system with new and useful impulses. This makes his approach particular interesting to counselors dealing primarily with clients from lower classes. Figures 7, 8 and 9 show some of the relationship structures Minuchin deemed “functional” or “dysfunctional,” quoting from a script developed by Dr. Margarete Hecker (Darmstadt, Germany). She studied under Minuchin and together with Verena Krähenbühl established the systemic advanced training program at the Evangelische Fachhochschule (Protestant Polytechnic College) in Darmstadt. She wanted to study under Minuchin because many of her students were working with clients from lower-class surroundings and needed an approach that would be effective with this group. The examples provided are equally useful for showing how to draw up relationship maps.
Figure 7: Examples for functional family structures
Figure 8: Examples of dysfunctional relationship structures
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Figure 9: Examples of triadic relationship structures
Figure 10: Examples for solution paths in structural therapy
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Background Text: Normative or Neutral Perspectives Minuchin’s work was one of the earliest approaches from the 1970s. At that time researchers were trying to depict the complexity of systems as realistically as possible in order to make them controllable and planable. To this end, various authors described the different aspects of social systems: Minuchin was concerned with relationship structures, Haley (2007) with strategic aspects and Satir (1990) with communication. Together they determined what is functional and what is dysfunctional in systems and thus causes problems. Such a method is called normative as it tries to explain what causes normal functioning. These results then serve as the basis for interventions in social systems, i.e., replacing dysfunctional with functional structures. The terms and symbols introduced above are all examples of normative procedures and point to central problems: – How do we define “overinvolvement” and what is simply “closeness”? – What is a “clear boundary” and what is a “vague boundary”? In 1990 Satir described in great detail how one can properly communicate and how dysfunctional communication occurs. Minuchin says a family must be structured such that it can raise children successfully and shows what happens in a family in which children have problems. Later generations of systemic counselors, however, did away completely with such normative approaches and were content to upset the existing state of equilibrium in a system (with all its dysfunctional relationship structures) and to instigate changes leading to a new state of equilibrium (hopefully with better functioning relationship structures). The latter approach was followed, for example, by the Milan team of M. Selvini-Palazzoli, L. Boscolo, G. Cecchin and G. Prata (2013, 1981). Exactly how this new equilibrium functions is left to the system itself: The Milan group places their trust in the wisdom and competence of the system. The counselors, in any case, remain neutral toward the result (i.e., the new condition); they have no opinion as to how that condition should or should not look. Mara Selvini-Palazzoli, in a 1979 interview with Klaus Deissler, said it as follows (taken in 2006 from http://www.systemagazin.de/buecher/klassiker/selvini_paradoxon.php): “Our families are clever enough to solve their own problems once I have interrupted their repetitive game. They are better at finding the solution than I ever could be. Minuchin is so certain what is best for the families. That is ridiculous, absolutely ridiculous. It’s the typical American concept: ‘I know what’s best for you because I’m a specialist. I know what’s best for you as a couple. I know what’s best for you as a family.’ Again and again I have had the experience that if I have been successful in interrupting the repetitive game, the family itself will find the best solution, even when I can’t even imagine what that solution might be. Three months ago we successfully treated a schizophrenic-catatonic girl in one session – the family found the solution – that was fantastic! It was a very good session, but the solution was much, much better
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once we had broken down the repetitive pattern. Almost immediately the girl recovered from her schizophrenia, and the family had to quickly find a solution – they stopped the therapy. Regarding therapy terminations, we differentiate between those stopped because of changes and those terminated because nothing is changing. In the case just described termination resulted because of change: The family knew how to find a solution without the therapist – indeed, a better solution that I could ever have come up with . . . Interviewer: . . . You interrupt the repetitive pattern and do not provide a solution . . . Selvini: . . . never, never, not once – neither I nor Dr. Prata, Dr. Boscolo or Dr. Cecchin tell the family what they have to do. Never! Interviewer: So you don’t consider yourself the educational instructor of your families? Selvini: . . . Never, because I have the greatest respect for my fellow human beings.”
The narrative approaches, which arrived later on the scene, are very distinct from the earlier normative ones. Narrative in this context means that as counselor one is interested in the client’s story and in the way it is told, in the client’s point of view toward life, in the problem at hand and in the possible solutions to that problem. The goal is to change the points of view (construction) of the persons involved, to dissolve them (deconstruction) and to allow new ones to arise. This way the members of the client system can re-experience reality and their own story anew and learn to behave differently. How this new story develops lies in the hands of the client and does not depend on what the counselor considers functional or dysfunctional. Steve de Shazer’s and Insoo Kim Berg’s solution-oriented method is such a narrative approach. Steve de Shazer (1992, p. 280) also differentiates his approach from the normative one of Minuchin: “I have learned to value differences, that differences are meaningful . . . As I see it now, this leads away from a position like that of Minuchin. He imagines a type of family ideal valid for all families. This produces an image of what a family is like and how such a family should function. I have seen families from many different cultures, and they all did very different things. But they all appeared to function properly, and they all had very different ideas about what functions – and it worked. Rational human beings emerge from such families. So why would I have a reason to assume that there is only one proper path?”
Both the Milan approach and the solution-oriented, narrative approach are neutral toward the solution emerging from the client system. Yet there are important differences between the Milan team and the solution-oriented, narrative position of Steve de Shazer and Insoo Kim Berg. We shall explore them in more detail in Chapter 4. The controversy we discuss here concerns the distinction between these and the normative approaches. At times it has been a hard and explicit fight between the two positions, as the quotes above clearly show. Yet we consider the controversy to be of major importance, and we consider our own experiences with these two opposing views to have been extremely fruitful. Nev-
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ertheless, no one must necessarily join a church every time there is a theological dispute. There is no single pill to cure all ills – unfortunately! (At least none that we know of.) Even if the normative approaches of earlier systemic authors have become somewhat old-fashioned, we still think they can be useful and helpful in the practice of counseling today. Once in a while we should take another look at them and see whether they have something to say about the case we are dealing with. All the while, however, we must keep in mind that these approaches demand a great amount of interpretation, construction and simple belief on the part of the observer, and that the instruments and terminology reflect normative thoughts about how a system functions or not. It is important to be aware of these prejudices. In our work we use these methods to reflect on our own approach and the results thereof, and to put them into perspective. Perhaps we can then spare our clients having to experience long odysseys in normative dead-ends – which happens quickly enough if one considers oneself to possess the holy grail of systemic therapy. But remember: This path is even easier to take if one is unaware of even being on – or actively denies being on – this track. Holding a position that regards results neutrally does not protect us from our own values and norms, which we then (unconsciously) try to implant into our clients. There are many contexts in which we are dealing with social control, where we consciously have to work with norms. In all other contexts we consider it better to reflect consciously on one’s own norms and to test them and rend them transparent. We will later return to this thought.
3.2.2 Remarks on Using the Map When working with the map the following procedure has proved advantageous: – The map quickly becomes confusing if one introduces comments on every relationship and every subsystem boundary. One must be rather selective, deciding which of the observations is important and which is less important for the question at hand. – Relationships between family members are not always or consistently the same in all situations. This means that systems are not rigid, but flexible entities. Put into the maps those relationships that are presently relevant for the counseling situation and the problems at hand. In other situations and with other topics the family will display other relationship structures. – In contrast to the genogram, when working with the family-helper map or with the timeline, we recommend against drawing up the map together with the family. Such a map includes many interpretations and assumptions on critical aspects of the family structure. These are in fact hypotheses that interpret and reveal things we don’t necessarily want to confront the client system with. Rath-
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Figure 11: Map of a nuclear family
er, we prefer to use systemic questions or sculptures together with the family members to view the interactions within the system. In this way, clients can come to their own conclusions about relationship structures (see Chapter 5). This method also strengthens the impression that structures are amenable to change, which is an important part of the counseling process. Maps – as helpful as they may be – tend to make relationships seem hard and fast and unalterable realities; they demand of their viewer a hardy portion of abstraction to see them only as the subjective snapshots they really are. Case example: Let’s go back to the Müller family (Chapter 3.1, Figure 4), whose genogram we viewed earlier. The family wanted help because of Paul’s school problems. The counselor connected the information given at the bottom of the genogram with that gathered by own observation and impressions from the exploratory sessions and drew up two possible maps. The first map (Figure 11, on the left) depicts the subsystem boundaries; the second map (on the right) uses the symbols to depict the quality of relationships. In these maps the counselor expresses his assumption that in school questions the father and son will join together against the mother, at least initially. In the first map he shows that the subsystem boundaries between the parent subsystem and the children subsystem are diffuse. Father and son (P = Paul) as well as mother and daughter (J = Jessica) have close bonds in this matter. This causes the hierarchy boundaries also to dissolve, at least sometimes. In the second map the counselor considers the conflict concerning the importance of education and training between the mother and the father to be a hidden one, whereas the conflict between the mother and her son with respect to his behavior at school is out in the open. This clearly reveals that, in the triad of mother, father and son, the conflict (between mother and son) is an open one, whereas that between mother and father may need to be resolved.
3.2.3 Action Possibilities: Dealing Creatively with Difficult Triads Difficult triads may develop not only in client systems; counselors are excellent objects for offers of coalition and enticements to take sides – particularly when the counselor was well trained in his own family to become involved in the conflicts of others. The danger lies in becoming partner in alliances, coalitions or triangulations – to save the wife from her macho husband, to stand up for the
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child toward the insensitive mother, to protect the husband against the unjustified demands of his wife. Here are a few suggestions for dealing with difficult triads or for disengaging oneself from enmeshed triads: – Know your own level of seduction: Which system member or what issue can best seduce me into entering into a coalition? This point also clearly shows how important it is to be well grounded before offering systemic counseling. – Free yourself from inflexible positions: It is important to retain (or regain) one’s freedom of movement and ability to act – particularly within the sessions. We can stand up, move around, sit with one member or the other, change seating arrangements, take on new positions and perspectives. Physical movement and change sometimes brings with it new agility to one’s thoughts and behavior. – Take the time to latch onto and to understand whatever appears foreign or incomprehensible: Whether it’s language, behavior, mentality or philosophy of life, these aspects of the members of a system are important, even if we have difficulty penetrating them. – Be clear about the mandates (institutional mandates, client wishes): Try to determine whether hidden or contradictory mandates have been introduced. – Point out mandates that are contradictory: Verbalize hidden mandates and then ask whether they are still valid. State clearly what is possible and what is not. – Clear up any open questions about who “owns” problems and who is “responsible” for solutions: By asking questions we can bring clients to assume responsibility and to define themselves (e.g., forward-looking hypothetical questions). – Take sides (and sometimes change sides), but only consciously and transparently, for a limited time and in a balanced way. – Slow things down: Give everyone the time and space to speak his or her mind. This serves to shed light on what is causing conflicts and which constellations are at hand. Especially when dealing with triangulations or redirected conflicts in client-helper systems the following has proved effective: – View yourself and other institutions as part of the system (and thus as part of the problem). Helpers and institutions too have their own interests – their own self-interests! Which ones are active? Can they be openly discussed? (see Chapter 4.1.6) – Conduct a systemic analysis of the problem that goes beyond the client system and investigates the participating helper system(s) as well. Draw up a map of the client-helper system that identifies potentially problematic institutional triads. – Make clear arrangements with any institutions that are participating or that did the transferring, while at the same time integrating the client system: Who does what? Who informs whom about what? Who is responsible for what? This is also true for any desired limits: Who abstains from doing what? (see Chapter 4.1.2) – Avoid allowing a hierarchy to arise within the helper system! Cooperating insti-
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tutions should not become our clients, but should rather always remain partners on equal footing. – Set up round-table discussions that include the client system and the most important institutions involved. 3.3 Family-HelperMap
3.3 Family-Helper Map The family-helper map is intended to facilitate orientation within the system, consisting of family members, informal helpers and professional helpers. Much like one uses a geographic map during a long hike in uncertain territory, such a map can be consulted whenever things become unclear. The family-helper map consolidates and visualizes many different pieces of information; it provides an overview of the case as a whole and allows a more clinical bird’s-eye view. Such a map concentrates and structures information by asking the following questions: – How large is the client’s family system? What is the client’s role? (genogram) – What informal support system, e.g., friends, relatives or neighbors, does the family have? (informal support system) – Who belongs to the helper system and which institutions are actively participating in the case (social services, school, kindergarten, counseling center, doctors, therapists, clinics, etc.)? How large is the helper system and is it manageable for both the helpers and the family? What do the individual members of the helper system know about each other? Do they know what the others are doing and what their respective role is? (existing helper system) – Which helpers were involved in the past but are no longer involved? How many helpers has the family had to date? (In a family with, say, three children, with a difficult social and familial situation, and with multiple problems with all of the children, we can be talking about up to 40 persons!) How often have the participants already told their story? How often have they already been helped? How often have they set up contracts with helpers? (earlier helper system) – What are the relationships between everyone involved, including between family members and helpers: close, distant, with or without boundaries, coalitions, alliances? (map according to Minuchin). Here, too, it is essential to include only the fewest possible, most important relationships (symbols) which clearly describe the most vital structures. The family-helper map would otherwise quickly become confusing and impractical.
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Background Text: First- and Second-Order Cybernetics Observers are part of the system The family-helper maps demonstrates one of the most important tenets of systemic work: It is not sufficient to look only at the family system; the family’s context – inasmuch as it is relevant to the question at hand – must also be included. Especially other active helpers greatly influence what happens. We helpers are equally part of this new system, consisting of family, informal helpers and professional helpers. This thought may seem obvious, but it represented a major step forward in the history of systemic therapy: It marked the transition from the first to the second level of cybernetics. If we put aside our role as helpers and view only the client system, we ignore the many reciprocities that exist between the system and ourselves. We are viewing the system as if it were purely as an object to be dealt with, whereas if we see ourselves as part of the system, it becomes clear that we must deal with how our views of the system and its members are influenced by our own position within that system. The prerequisite for analyzing our own position is the ability to differentiate between the various levels of observation in the system. These levels are described in the following illustrations and texts. A system (e.g., a family) A family with all its relationships, communication patterns, history, culture and conflict rituals is depicted in Figure 12. If an observer (counselor) were to observe and describe this system, the result would be something like that given in Figure 12. Yet the observer does not exist in this description! The description asserts the claim to objectivity because the observer is not present (first-order cybernetics). Systems and their internal workings would appear to exist exactly as the observer denotes. This method obscures the fact that all descriptions are merely the perceptions and assumptions of an observer.
Figure 12: A system (e.g., a family)
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An observer system: Counselor plus family (see Figure 13) Together with the counselor the family forms a new system in which the main themes are communication, family structure, its relationships, communication patterns, history, culture, etc. For example, in this observer system the counselor could let a sculpture be done depicting all of these things. We speak of second-order cybernetics only when the fact has been admitted that the observer interacts with the system, that all observations and all hypotheses of the counselor about the system are not objective but rather the result of such interaction, filtered through the cognitions, opinions and assumptions of that observer. The structures and even the system boundaries of the family are all assumptions made by the observer and not objective facts (see the Background Text on “What Is a System?” in Chapter 2.2).
Figure 13: An observer system (counselor plus family)
Observer-observer systems: Supervision group or team (see Figure 14) In this constellation a group of observers observes and analyzes the interaction of another observer with a system. This is the case in supervision or a case-management meeting. The group makes hypotheses concerning the interaction, for example, about how the helper can initiate change in the system by own interactions, or why such a change has not previously been possible. The family-helper map, which includes both the observing and the intervening counselor, is the driving force behind the idea of second-order cybernetics: The observer is part of the system! A counselor’s own observations, standpoints and assumptions about the system cannot be isolated from his or her own position and relationships within the system. Family-helper system (see Figure 15) A family-helper system can be an observation system with several observers (helpers) with their respective hypotheses about the dynamics of the family. These hypotheses depend, among other things, on the context of the respective helper, their relationship to the family and the institutional mandate. Fur-
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Figure 14: Observer-observer system (supervision group or team)
Figure 15: Family-helper system. The figure shows an example drawn from youth welfare services. For readers not familiar with the terminology in this field here a few of the pertinent abbreviations: GSS = General Social Services, whose role it is to carry out the laws pertaining to children and adolescents, among others, protecting children from abuse and supporting families, children and adolescents. The GSS is usually the authority that sets up the interventions to be taken on behalf of the family. FA: Family Assistance, the authority that carries out the measures decided upon by the GSS and maintains contact with the family. The family gets its direct support from and is accompanied by the FA. The FA counsels the parents and, together with the parents, works out the details of daily life, often directly in the family’s living quarters.
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ther, the helpers have relationships among themselves as do their respective institutions. Thus, there is a danger that the individual interventions of the many helpers could disrupt instead of complement each other. If there is an impasse in the work with the family or disruptions in the cooperation between the various establishments, it may be advantageous to build some hypotheses concerning the interactions going on in the family-helper system. The helpers and the family member involved are greatly influenced in their hypotheses about the dynamics of the family-helper system by their own perspective on the system. At this juncture a new level of observation may arise – that of a supervision group or professional team. The observers of a family-helper system use the external perspective of such a viewpoint to suggest new hypotheses about the dynamics of the family-helper system. This in turn forms the basis for new interventions to bring about changes in the family or in the cooperation of the helpers involved. When working systemically with families, other helpers, professional teams and supervision groups, it is important to distinguish between the various system and observation levels: – Which system are we describing now? And what is our role as an observer in this system? – How influenced are our hypotheses by our own perspectives within the system? – From what perspective and in whose interests are we writing reports and official statements and making decisions? – How can we take into account the perspectives and actions of the other helpers when setting up cooperations, agreements and relationships?
3.3.1 Drawing Up a Family-Helper Map The basis of any family-helper map is a complete genogram with all levels of family relations. The informal helpers can be grouped around the genogram. The professional helpers involved should be entered in the lower part of the map, with past helpers best listed under a line at the bottom part of the map. Besides the basic facts determined during the exploration, the map should also include information and assumptions concerning the relationships of the system members. Draw in the most important ones with the help of Minuchin’s relationship symbols. Assumptions about relationships that seem vague, or if one is uncertain or consider them of lesser importance, should be excluded at this point, for the following reasons: – A proper overview is sacrificed if there are too many relationship symbols present. A geographical map that contains every single stone and bush is a poor map indeed.
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– The map is an important tool for documenting the case – but not for recording every fleeting thought about the case. – The map should be such that we can show it to other colleagues. That means eliminating all speculative assumptions about the relationship network which might cause unnecessary irritations.
3.3.2 Notes on Recording the Informal Helpers In this step those persons who support or are important to the client system are introduced onto the map. This can include friends, relatives, an adolescent’s peer group or other important consultants such as pastors, godparents, mullahs and imams as well as the classical helpers and healers of the respective culture (magicians, witches, healers). These various sources of help can be very important to persons from other cultures who may not be accustomed or willing to turn to Western psychosocial counseling centers with their developmental and familial problems. We usually try to actively query foreign clients concerning such traditional cultural helpers since they may not come forward with this information on their own: They think we are not interested or do not take them seriously. The social system of a street gang may provide a 17-year-old delinquent with useful suggestions and solutions – albeit different ones than a social worker or counselor might come up with. Likewise the friends from home in Morocco might give a Moroccan man whose wife and children have moved into a women’s refuge very different advice about what he should or should not do in the situation and offer him other practical tips. It is important to note these influences and give them a symbol on the map. Otherwise, we may overlook relevant and important elements within a system. In particular we may miss the valuable resources that lie in such informal helper systems and can be implemented in our interventions to ensure a success therapy.
3.3.3 Notes on Recording Professional Helpers in the Map We recommend a thorough exploration of the professional helpers who are presently working with the family or have worked with them in the past. Ask about the goals that were set, about the intensity of their engagement, about their successes and failures. It is also interesting to find out what the individual family members learned from previous helpers and how, why and by whom their efforts were terminated. (Such questions are given in Chapter 2.3.1 for use in explorations.) Taking too little time to elicit this information will inevitably be punished in the long run: You will inevitably miss out on the perspectives of other professional helpers toward the same problems you are now confronted with, or how the family system has dealt with such helper relationships! It may make you feel good to be unique and exclusive, but it definitely damages your realistic chances of
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achieving success with the clients. Above all, in this way one fails to learn from earlier attempts at intervention. The map should contain the names of the helpers’ institutions in squares. We recommend entering the actual persons from the institutions involved with whom the family had contact as well as those persons from the respective institution who played a major role in making decisions or participated in helper conferences.
3.3.4 Key to the Family-Helper Map Up to now we have entered on the map mostly the facts learned during the exploration. But putting in the relationship symbols according to Minuchin now means entering one’s own points of view and observations regarding the relationships. The key on the family-helper map can also document the perspectives of the most important persons in the family-helper system. These are determined by asking the questions suggested in Chapter 2 (What are the family’s strengths? What is the problem? What would be a good solution? What does this person expect from me as a helper?). Note the positions of each person on a separate piece of paper that can be added to over time. It is also helpful to make sketches of the most important belief systems, convictions, value systems, etc., of each of these persons (see Table 2 above). This method also reveals which of the positions we have given the greatest attention to: Which page has the most entries – and which has none? Whose positions were more (or less) carefully documented? Once again we are dealing here with one of the most basic tenets of systemic work: Systemic counselors feel obliged to remain neutral. In practice that entertaining all perspectives of the system, every point of view of every participant. The counselor must always see to it that the individual positions in the system are not discriminated against, simply because – they take up less time during the sessions, – they incite less curiosity and appreciation in the counselor, – they are less well documented. Documenting the positions of the individual system members in the key to the family-helper map reveals the following: – which of the system members I am attracted to – or not: social neutrality; – which of the system members captures my attention and engages me – or not: social neutrality; – whose behavior, problems and explanations I more readily accept – or deny: neutrality toward process; – whose goals, solutions, points of view and interests agree with my own – or not: neutrality toward outcome; – toward whom I am more lenient (or harsh), whom I know best (or least), whose interpretations get lost (or always come to the forefront): social neutrality;
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Background Text: On Neutrality Systems may be viewed from many different vantage points (Morgan, 2006): – technically, as the logical intermeshing of different feedback loops. – biologically, as organisms that adapt again and again in order to survive under new circumstances; as organisms that strive to secure the satisfaction of their needs and thus their own survival; or as organisms whose main task it is to regenerate themselves both from within and from without via activity. – psychologically, as a place where the psychological needs of the participants are staged, for example, creating something together that extends beyond death (children, a house, a company, etc.); or roles that are acted out (the princess, the fool, the king’s murderer, the warrior, the diligent one, the vamp, the lover, etc.). – politically, by recognizing interests, power distribution, struggles for selfassertion, strengths, weaknesses, fear of failure, parties, coalitions and neutrality. Of particular importance for all social systems – families or organizations alike – is the political moniker one looks through. This aspect must receive special attention when a new helper is added to a system. Adding new parties and new power distribution plans this inevitably changes the previous political equilibrium. Such a situation is important to the participants because the system is usually unstable and at danger at exactly those points of time when new helpers are added. This is why the new helper is seen an important participant in the future development of the system: – How much influence does that person garner? – To which party does that person belong? – Which party suggested adding that person to the system and why? – Does that person remain neutral? – Does that person sympathize with the values, goals, beliefs, solutions and programmatic positions of a particular party? – Does the person endanger one’s ability to assert their own interests? – Can that person be utilized by someone to assert their own interests? If it is our goal to be a counselor to the entire system and not a partisan to one side or the other (consciously or not), then we need a certain measure of neutrality, if only to be accepted by all participants of the system as a counselor. For this reason, systemic therapists and counselors began early on to concern themselves with various concepts of neutrality. One early suggestion was that of multidirected partiality (BoszormenyiNagy, 1985; Stierlin et al., 2002). According to this principle, the counselor should be able to identify and side with all participants of the system – throughout the entire duration of the intervention. This idea is difficult to
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realize because it demands a great deal of internal flexibility and great breadth of empathy. It is also difficult to test or even observe this in everyday situations. Later there evolved the concept of neutrality (Selvini-Palazzoli et al., 1981), in the sense of a continually changing partiality. In this scheme the counselor allows space for new system points of view or perspectives, is interested in those positions, examines them, and tries to understand how they affect the interactions within the system in both the past and future. If the helper does this in a relatively fair manner with respect to his or her own available curiosity, time, interest and appreciation, then something approaching social neutrality can be reached. For many systemic counselors this concept appears to be easier to manage because it emphasizes the successive pattern of attention paid to the various persons in the system. Unlike multidirected partiality, it focuses more on concrete behavior than on some inner disposition. Whether each person in the system has in fact been treated more or less equally becomes apparent in the course of the session. Thus, the concept of neutrality is easier to verify and operationalize than multidirected partiality. The idea of neutrality forms the basis of the conscious and systematic questioning of the various points of view and their documentation in the key to the family-helper map. Neutrality in this sense of the word does not exclude the counselor from having own opinions. Thus, we differentiate several different types of neutrality: – The counselor can be socially neutral by favoring no one and being equally interested in all positions of all persons involved. – The counselor can have neutrality toward the outcome (Simon & Rech-Simon, 2012, p. 26 ff.), meaning the counselor is indifferent to whether one solution or another comes to be accepted (whether the son moves out or not, whether a couple separates or stays together, whether the solution suggested by colleague A or colleague B wins out). – The counselor can be neutral toward the process, i.e., impartial to whether the problems have to be solved quickly (different parenting styles, the daughter hangs around all day, aggressive behavior in the team) and impartial to whether the explanation of one person or another better reflects the root of the problem. Often we have very clear opinions and must be able to defend them. Sexual abuse and physical violence are not good solutions in a family: There is no room here for neutral expectations. Social services are state-run organizations. They represent societal values (e.g., children enjoy special protection). If we are a part of such social services, we cannot be completely neutral about the solutions our social system prefers for existing problems. Of course, there is always leeway within these limits to shape the state of social systems. There are many different acceptable lifestyles that we can – and indeed must – treat neutrally. Still, we should be clear about the following:
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– When do we harbor neutral outcome expectations – and when not (own – – – –
values and positions)? When are we comfortable with being neutral toward the outcome? When do we have to maintain neutrality toward the outcome? When is neutrality completely wrong? Above all: What consequence does our neutrality or nonneutrality have on the system?
Whereas social neutrality (sensu Selvini-Palazzoli) is an appropriate and essential position when working with systems, each new case demands our attending to the question of neutral outcome expectation – especially for situations in which decisions are to be made: Neutrality is not always the best choice there. In Chapter 4 we look at these matters more closely.
– whose positions and interests rather receive my personal sympathy and whose don’t: neutrality toward outcome; – whose positions and interests conform to my institutional mandate – or are diametrically opposed to it: neutrality toward outcome.
For these reasons, the key on the map serves not only as a documentation to better understand the system participants. It also serves as a good basis for me as counselor to deal with the question: How neutral am I really? And, of course, is it OK the way it is? Such documentation also helps us to foresee both future pitfalls and opportunities in the interactions between the counselor and the various members of the client system in a political sense (neutrality, interests, coalitions) and to analyze their risks, chance and side effects. 3.4 Timeline
3.4 Timeline Up to now we have been concerned with documenting and organizing the information that defines the present state of our system: Who belongs to the system? What are the relationships within the system? Who represents which points of view? But systems also have a past that is not unimportant to our understanding. There are three aspects to the history of a system: – the developmental history of the system: family case history, the history of an organization or a team; – the developmental history of the problem and its development over time: particularly important in systems with chronic problems – history of the symptoms, the disorders and problems; – the history of the attempts to find solutions through own resources or with professional help: history of previous attempts at solving the problem.
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Existing information on these areas can be documented with the help of a socalled timeline that presents and visualizes previous efforts in a chronological fashion. This enables a bird’s-eye view, which in turn provides a more general overview and emphasizes relationships. The timeline orders the helper’s information into a history of the system and helps to prepare hypotheses. Below we touch on some relevant questions regarding the three aspects mentioned above. Developmental history of the system: Which distinctive events have shaped the system and its history: marriages, separations, extramarital affairs, moves, unemployment, new family members, births, deaths, sickness, changes of status of important persons or caregivers, etc. Here, too, one should limit the list to only the most important events. Depending on the situation some aspects may be more important than others and need to be documented on the timeline accordingly. For example, when working with juveniles it is important to know who was the child’s main caregiver and at what times, whether there were any changes or separations from caregivers in the past. The history of a child’s attachment often plays a key role in understanding the present situation. In organizations and teams, on the other hand, the question may be a very different one: Who founded the group and under what circumstances? Did it at any point increase in size? Did any other important changes occur? Did competitors come into play or leave the scene? What were the past circumstances and how have they changed over time? Were there any changes in the administration, structure or personnel at decisive points in the system? Have the financial modalities changed in any way over time? Developmental history of the disorder: When did signs of the problem first occur? Have they increased in strength? Decreased in strength? Changed at all? Were there fluctuations over time? Did new and different problems occur? What other changes occurred simultaneously? History of coping and previous attempts at solving the problem: Were there any experiences of success and overall good times? What hurdles did the clients have to overcome and how did they succeed? What did the clients try on their own to solve the problem and what were the results of their efforts? What did informal helpers suggest? When did professional helpers enter and leave the picture? What was undertaken and when was it undertaken? Recording this aspect may take considerable time, patience and interest as it doesn’t concerns present problems, and the members of the system may have little motivation to talk about past (unsuccessful) attempts. Persistent querying and active probing – with due respect to the limits and coping skills of the clients – are necessary. Information obtained here is very useful, but need not be gathered during a single session or even at the beginning of counseling.
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Background Text: Contextualization – The Temporal Dimension The timeline serves to document information on the history of the system, the system’s problem and previous attempts at finding a solution. It puts things in order and provides an overview of what is known. In addition, it is capable of temporally contextualizing problems and placing them against the background of a historical development. In genograms, maps and familyhelper maps we can contextualize symptoms or difficulties by connecting them to present system constellations and relationship structures. The goal is to determine (or invent) connections between family history and system history, attempts at finding a solution and the problem history. This in turn opens up other ways of explaining or viewing the problem and its consequences. The idea of putting the history of a problem in a temporal context was introduced early on in the development of family therapy (see, for example, Minuchin, 2012; Carter & McGoldrich, 1989) and was foreseen above all in conjunction with life phases and passages. Carter and McGoldrick describe the typical tasks humans face during the various phases of family life: leaving home, finding a partner, having children, children go to school, adolescence, children leave home, becoming a grandparent, retirement, death and loss. The hypothesis of critical events leading from one phase to the next forms the basis of this school of thought. Viewed from this perspective, problems can sometimes play a meaningful role by slowing down or even stopping the transition process. For example, the neglected or immature young adult child can keep the normal parent-child activities going for a long time. Or when a difficult phase of marriage follows the birth of the first child, which may point to the couple’s failure to find a balance between old and new roles. In their phase model of the development of organizations, Glasl and Lievegoed (1996) describe how the transitions from one phase to the next can become the origin of new problems and crises – a plausible conclusion since any transition confronts the people concerned with more or less difficult changes. A transition can be successful or it can fail, depending on the contextual circumstances and the coping mechanisms present in the system. Regardless of whether these models prove tenable in all conceivable cases, they are useful hypotheses for dealing with problems such as normal transition crises. This can be a relief to many clients and often allows them to gain a new perspective. It steers them away from exasperation and self-reproach and toward recognition of the necessity for change and the search for practicable solutions. The goal is not to establish a complete and linear causal chain (“because the separation happened, the symptoms appeared shortly thereafter”), but rather to describe the reciprocal effects (circular processes) in the sense of the effects a problem has on the development of the system or on the attempts
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at solving the problem. The timeline can help one to form hypotheses concerning the relationship between a life situation and a disorder – and thus offers assistance in defining the makeup of our professional support.
3.4.1 Designing the Timeline We use the following elements to construct the timeline (Figure 16): – The timeline proper with information on the year or month lies in the middle or upper third of the figure. (Here, too, we recommend using a flipchart in landscape when setting up the timeline together with the client.) How best to partition up the timeline will depend on the case at hand. Sometimes past events are put more closely together since there is generally less to report on, whereas more eventful times are given more space. – The most important events in the family or organizational history are entered above the timeline. – The development of the problem or symptom is entered directly below the timeline. – The lower third of the figure is reserved for denoting resources, past experiences and previous attempts at finding solutions.
Figure 16: Example of a graphic depiction of a timeline
3.4.2 Working Together with the Client on a Timeline Experience shows that clients enjoy working together with the counselor on preparing a timeline. That has a number of advantages: – When clients recall events from the past and these are entered into the timeline, it triggers their memory of even more events from that period. We all know this phenomenon: The more we think and speak about a past event, the clearer it becomes in our mind. Warming up old memories tends to activate all sorts of
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associations – and visualizing them in the form of a timeline supports this process considerably. Clients often have a rather disorganized picture of their own past. Looking at it together with someone can often bring a better overview and more order than previously possible. Grawe et al. (1999; see Chapter 5) regards such experiences as important factors contributing to successful psychotherapies. With chronic problems the clients may have already consulted many different helpers – and they can no longer remember exactly who suggested what or what the respective results were. Getting an overview and reflecting on it together with the client can be very helpful to the new counselor; resources are activated and dead ends avoided. During an anamnestic interview, many clients like to see exactly what the interviewer is writing down. For many clients working with a sheet of paper that both parties can see is better than just talking about things while facing each other. This is especially true of adolescents. When looking at the timeline together with the client, give the client some time to peruse and think about the result. Clients often develop their own theories and contextualizations that would not have arisen without the visualization.
Case example: The following stems from a supervision in a child and adolescent center, where one of the adolescent clients reported the following: Sonja, 14 years old, did not keep to the rules. She was always running away and often had to dramatically be retrieved by the police – only to disappear again after a few days’ time. She had spent little time in school and had a huge file at the welfare services. The social workers were at their wits’ end: All of their attempts, even those involving closed institutions, had proved ineffective in the long run. In the supervision group we were all rather helpless and perplexed at this phenomenon. It was the timeline that helped us further: Sonja was from a Roma family and had early on experienced many relocations. Her timeline (Figure 17) showed what had been known previously from the oral report, but not completely realized: Sonja was acting exactly as she always had in her family. She had moved around a lot and had, following the disintegration of her family, been put in a number of foster families. She had established relationships neither to the localities and nor to the persons there; her home was wherever she was passed around to next, her family consisted of those who took care of her for a while. Against this background it became clear that any attempt to offer her a specific place to live with unchanging caretakers would not work. From the resources analysis we knew there was an aunt, and one of her caretakers was particularly important to her. This led to the following suggestion: Sonja was to be put into a single room in an assisted living facility for juveniles along with the caregiver she liked so much. The caregiver initially did not demand much of Sonja; she simply followed her around and was available to her if needed. This strategy was not a little risky (in a legal sense too) and had first had to be discussed with the courts and with the police. After a year’s time Sonja had stabilized and showed increased interest in her own perspectives, including a possible vocational training. She spent more and more time in her own apartment and even went back to school (with much special educational support). She did not completely stop roaming around, but her “trips” now tended to be less often and shorter.
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Figure 17: Example of a timeline
3.5 Sociograms:TheGroupasSystem
3.5 Sociograms: The Group as System In Chapters 2.5.2 and 2.5.3 we described methods with which we can observe and record the social dynamics of systems – in residential juvenile groups, in groups of children in homes, at school or in nursery schools. In this chapter we introduce the methods used to organize and document these observations. The symbols suggested by Minuchin for maps (see Chapter 3.2) generally describe, organize and document the social dynamics found in families. But this language of symbols, with some additions and supplements, can also be used to describe other systems, such as groups, teams or whole neighborhoods. We understand the social dynamics of a group to be the relationship structures, the social roles and the subgroups that emerge during interactions and enable a group to function and act as a group. Whenever we create sociograms with the help of Minuchin’s symbols we use circles and squares for girls and boys, entering their age and symbolizing their emotional proximity or distance by putting them closer or further apart. Also, we can depict the quality of the relationships by employing symbols for closeness (choice of joint actions and games) and conflict (rejection). We construct social dynamics from our observations – how individuals in the group react to each other, who wants to be with whom, who rejects whom. But
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Figure 18: Typical patterns for recording social structures and roles in a group (on the symbols see Figure 6 above)
there are also other observations we can make in a group (see the questions given in Chapter 2.5.3): – What are the values, interests and needs that link the subgroup together and which of them are associated with the individual members? – What are the common group activities? Are there common interests? What do the subgroups do together to have fun and what do the individual members prefer to do alone? We suggest adding the observations from these questions to the subsystems. Normally, the results of our synopsis of the social dynamics of these aspects provide a better understanding of what lies behind the social dynamics of the group. The interests, desires, needs and values – weld the group together if they are similar or identical, – drive the group apart if they preclude each other, or if they are felt to be somehow threatening or dangerous, – can prevent some individuals from gaining access to the group. With this information we can, as the person responsible, develop hypotheses about what motivates and drives the group members. This in turn provides us with inspirations for particular interventions, activities, work structures and ideas
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on how to design our interactions with the individual members or subgroups (see Chapter 4.5). Methodologically speaking, we suggest proceeding stepwise as follows: – First, chart the social dynamics observed in the interactions in a sociogram. – Second, add the actions, interests and values of both the subgroups and the individual members. – Third, draw up hypotheses based on these results and plan the respective interventions.
Background Text: Sociometry and Group Dynamics Were the Earliest Approaches to Systemic Thought The methods described here did not emerge solely from systemic work, but can also be found in older traditions present long before systemic observations of social systems led to the conclusion that social contexts play a major role in the development of human beings, their well-being and their productivity. Part of this tradition was the work of Jakob Lewis Moreno (e.g., 2001, 2008), Kurt Lewin (1951) and Bradford, Gibb and Benne (1964). Many of their methods for recording the interactions and dynamics of social systems are useful when working systemically with groups. In some of these approaches the behavior of the individual is not causally related directly to his or her personality, but is rather seen as part of a reciprocal relationship with the particularities of the group and the personalities present in that group. This sort of interaction between the characteristics of the group and those of the individual can be understood as a circular process. How closely systemic methods resemble these traditions from group-oriented psychotherapy becomes clear when we compare Minuchin’s family maps and the sociograms Moreno (1953) drew of groups. Below, we concentrate on two particular research approaches to groups that have proved extremely useful for the study of groups as social systems. The first approach is that of J. L. Moreno, who early on recognized how dependent a person’s well-being is on the respective context. His book entitled “Who Shall Survive?” (1953) describes his experiences after World War I as a young doctor treating dislocated farmers in South Tirol, who had been driven from their farms and were now living in a refugee camp. All the residents of the camp were living under the same (very poor) conditions, yet it was his observation that those patients who came to him with extreme vegetative afflictions were living in barracks full of stress, anger and tension among the dwellers. The “healthier” camp residents, it turned out, were living in family barracks together with family members as well as old and new friends. Moreno’s conclusion was that the well-being and health of humans greatly depends on whether or not they live within a network of well-meaning others or whether their life is full of adversity. He studied workgroups and
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other systems as to how much choice (sympathy or positive energy) or rejection (antipathy or negative energy) the individual members enjoyed, depicting the results in the form of sociograms and tables (sociometric tests). These sketches and sociograms were generally based on real enquiries and directed toward measuring social relationships. We use this instrument to depict observations made by the team leader or an outsider. The roles described in Figure 18 (p. 89), such as “star,” “unseen,” “excluded,” “subgroups” and “couples” are borrowed from Moreno. The second model is that of Raoul Schindler, who in 1957 described ranking orders in groups. He focuses on social roles that occur in all types of groups and guarantee group existence. This approach was also an attempt to understand what went on in the social system of Germany during the socalled Third Reich. His approach was a fruitful one for systems theorists because he was able to depict the dynamic reciprocity of various functions (what Schindler called ranking group positions) and their interactions in a social system. Figure 19 shows the ranking group positions. The double line between Alpha and Gamma expresses the closeness of their positions; the dotted line between Beta and Alpha as well as Gamma symbolizes the greater distance between these elements. Beta takes part in the actions that Alpha suggests (which the participants at the Gamma position are also part of), but Beta is more dissociated, has doubts or wants modifications to the plan. The
Figure 19: Schindler’s ranking group model
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line connecting Omega and Alpha as well as Gamma represents conflict. Omega’s connection to Beta is not necessarily one of conflict, but it is in any case less intensive. In Chapter 4.5 we describe group situations that can be well understood and graphically represented with this model. One major advantage of this model is that it makes clear to all that Alpha actually supplies the participants at the Gamma position with something: Alpha clearly expresses the interests, values and needs that appeal to them; Alpha also has the ability to translate these expressions in the form of attractive actions and to communicate them in an engaging way to those at the Gamma position. In our opinion, this model is not capable of properly depicting processes in large groups or, say, the developments in fascist Germany in the 1930s and 1940s. But in smaller groups of up to 25 members it can offer a useful perspective for describing system dynamics. A further advantage of this model lies in its creating a connection between social dynamics (closeness, distance, partialities, attraction, hostility, rejection, subgroups, etc.), on the one hand, and psychological dynamics (the values, needs, issues and interests of the participants in a particular context), on the other hand. This allows insight into group processes and reveals that the junction of the individual and the context determines what happens in the system. A rather weak and awkward, reserved young boy who is interested in logic puzzles and reads a lot will hardly be able to assume the Alpha position in the local soccer team – he may even (depending on the conditions) be condemned to assume the Omega position (much to his own chagrin). In the local chess club, on the other hand, he might advance to the Alpha position, whereas the boy in the Alpha position of the soccer team could easily land in the Omega position of the chess club. Let’s look more closely at the first boy: At school he might be stuck in the Omega position up to age 13, since athleticism, strength and male boasting are dominant values in his class. At age 17, however, he could switch to the Alpha position when the previously dominating factors of physical prowess have changed to intellectual and political interests. This move from Omega to Alpha position is a very real possibility when the group changes its orientation, interests or values. This scenario also shows that there is no “Alpha type” as such; rather, whoever assumes this position does so because of certain contextual conditions that fit that person’s personal skills and willingness to assume the role. Raoul Schindler assumes that all of these positions must be occupied to ensure group stability and viability. The objective is thus not to prevent the positions from being occupied; if we want to assume a position of responsibility for a group, then we have to endure there being some people who end up in the Omega position, certainly not always a very thankful position. We must also accept that some group members consciously choose and accept
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being in the Gamma position, or that the persons in the Alpha position do not always act democratically and sometimes push others aside. For those of us who work in psychosocial professions this can be a very trying experience indeed! Our ideas of harmony, our own values (“liberté, egalité, fraternité”), our ethical imperatives, our conception of “right and wrong,” our belief system – these sometimes just get in the way. If one’s goal is to further the wellbeing of humans and the viability of a group, then a certain measure of flexibility and tolerance toward changes in the positions within the group – and especially respect for all positions taken – is necessary.
.5 Sociograms:TheGroupasSystem 3.6 Reports
3.6 Reports Sometimes reports have to be written for external employers or for internal reasons. A report can also serve as the basis for further planning and decisions. The courts demand expert opinions; health insurers need reasons to continue care; final reports are sent to experts who in turn become actively involved. Further, case reports as well as therapies and their effects have to be documented. In practice we see many solid, informative and succinct reports – as well as pages upon pages of information with no orientation whatsoever. Most institutions have templates to be used for such reports, which correspond to the legal and practical necessities and are developed as part of quality-management systems. For that reason, we will provide only a few indications about what makes a good report, a concrete suggestion to serve as motivation, and a case report. Finally, we would like to give a few pointers on choosing useful elements for a proper system-oriented report.
3.6.1 Criteria for a Good Report – Write the report together with the clients and give them a copy of it. This method guarantees use of clear and simple language. – Within the report, separate sections should be devoted to what was actually undertaken with the client, what was observed and learned in the process, and to one’s professional judgments and assessments. – A report is easier to understand and use if it describes the most important aspects shortly and succinctly. Anything longer than 2–3 pages serves only to water down the meaning. If this cannot be avoided for strategic reasons (e.g., a court demands extensive descriptions), keep the structure as lean as possible, breaking down the text into central statements and accompanying descriptions, so that the reader can quickly grasp the gist and later be concerned with the details.
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– Graphic and concrete descriptions garner a greater understanding and acceptance of what is being described. Instead of stereotypical abstract generalizations (“Peter has pronounced dissocial characteristics, particular in performance requirements at school”) use concrete descriptions of what actually happened (“Peter was rude to the teacher and runs out of the room if he is called on in class and doesn’t know the answer”). – Consequently, use more verbs and less adjectives and nouns. Write “Petra helps her mother several times a week with the dishes” instead of “Petra is cooperative.” Or “Simon fails to come home several nights a week. He pays little attention to his clothing and personal hygiene” and not “Simon may already be considered a runaway with clear signs of neglect.” – Many reports consist solely of a list of deficits. In systemic-oriented reports, however, it is of utmost importance to include the resources present in the system, any positive results achieved at solving the problems and the context of the problematic behavior. – Reports tend to be more vivid and readable if they contain at least some of the visualizations mentioned above.
If the contractee and the situation allow it, we like to employ a graphically oriented template that puts the most important pieces of information in a clear and neat order. The advantage is that the most important information is consolidated on one page, which in turn forces one to be selective and succinct. On the other hand, using shorthand descriptions bears the risk of leaving out all the shades and nuances when selecting what is deemed important or unimportant.
3.6.2 What Dimensions to Include in the Report The answer to this question depends on the field of study, the goal and who is contracting the report. But it is worthwhile to use a theme grid as a checklist. We enter into the list all areas of information we may need to develop our hypotheses. Obviously, everyone has their own favorite topics, depending on the respective professional focus – we have areas we explore in detail and others we tend to ignore. A theme grid, however, demands precision of us by forcing us to look at every single area, even those heretofore neglected. Of course, it would be nonsense to go through every single area during the first phase of contact with the client; we don’t want to torture the client for the sake of completeness, which would inevitably cause the clients’ trust to wane. We necessarily have to choose which information to deem important and valuable to our goals. Using the theme grid as a sort of self-inspection helps us to make such decisions based not on subconscious inclinations, but consciously and according to professional and replicable criteria. In practice, we also find the following advantages of this method: – When planning an intervention, I go through all the relevant areas and carefully
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Table 4: Theme grids for exploring aspects of family situations Family situation
Risks
Resources
Notes
1. Familial status Family structure Parental care Place of residence 2. Economic situation Income/support Debt 3. Work situation School/vocational training Employment Working hours 4. Living arrangements Living space Residential environment Social network 5. Parental background Parents’ childhood Stressful events Earlier relationships 6. Present stressful life events In the family External circumstances Traumatic experiences Coping strategies
put the information I have received in order. I look at the risks and problematic areas with an eye toward their interaction with the symptoms or syndrome in question. I compile the possible foci of intervention based on the “findings” (“finding” derives from “to find,” and as constructivists we know that in every finding resides an opinion; see Chapter 4.4). – Resources are often overlooked. That is perhaps the greatest benefit of such a list since its rigor forces us to look closely at those areas where things are going well, where coping is actually working. It requires us to denote all those everyday tasks that are successfully being mastered and that are often taken for grant-
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ed. We need to register these strengths, put a name to them (De Jong & Berg, 2012) and utilize them (Durrant, 1993). – Such a list also serves to point out all the empty spaces on our own map. One can then plan further contacts to collect the relevant data. Or one can ask: Why don’t I know anything about this yet? Why didn’t I ask about it earlier? Did I overlook it? Or did I not have the courage to ask? Did the client hide the information from me or sidestep its mention? Should I leave it be or would that be a major sin of omission? – Finally, the list proves useful when preparing the information for a report. One can complement one’s own observations and define the most important areas to include in the report. It is thus a good preparation for conversations about setting up counseling or other help schemes. For the area of youth welfare services, the Bavarian State Youth Ministry (2005) issued materials to help in preparing diagnoses in social services interventions. The materials have the advantages described above. We have modified them for our own purposes and present the reader with parts of them as inspiration for own creations (Table 4, p. 95).
3.6.3 Progress Reports for Evaluation Purposes and Planning of Interventions The following example illustrates how one can apply the report grid to evaluate an intervention and to simultaneously prepare for the next intervention (Table 5). It was prepared with the help of colleagues from an emergency-care group who determined the content of the cells based on their own experiences. The information gathered is entered in shorthand, as is any information on previous interventions based on the perceived effectiveness thereof. In case studies this point is often very important: Particularly in the most desperate cases it is worth searching for those interventions to which the clients reacted positively – if only minimally. They can provide important clues on how to continue. In the next step one formulates the main hypotheses and writes them down along with the activities deduced from them. The main hypotheses are those that are behavior-driven (see Chapter 4.2).
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Table 5: Report grid from youth services. The case is of a 13-year-old named David who has been living in an emergency-care facility for 2 weeks. A genogram and a relationship map were also available.
Family
Present state
Problems
Resources
Parents divorced for 4 years, both now have new partners David alternates living with mother/father Father has custody; David to go to mother; both parents stressed and unwilling to invest time in David
Father: doesn’t come home for days, smokes pot, conflicts between Father and David; in court for stealing, mother unreliable
Close contact to mother (calls her often, wants to live with her)
Poor grades since 3rd grade, skips school often, changed school often
Used to be good in math, likes to go to school, good contact to one teacher
School/job Back in school since last training Thursday (7th grade middle school)
Group in emergency care facility
Adjusted quickly, good contact Sidesteps rules, particu- Helpful (cooking), to other children/adults larly curfew; someself-confident, times obtrusive quickly makes contact with others
Recreational activities
Many contacts in the home, very active
Hangs around with old- Likes sports, active er kids, smokes, drinks alcohol
Friends
Others interact with him
Dominates weaker kids Supports others, shares with others
Miscellaneous
Well-groomed, independent, polite
Enjoys being center of attention, talks a lot, interacts
Previous efforts (2 weeks)
Positive (effective): opens up during collective activities, approachable via motivation (see school record)
Negative (ineffective): restraints, rules, admonishments – accepts them but then skirts them
Hypothesis
Following his parents’ very conflictual divorce, David has failed to find reliable support. He quickly learns to make contact with others and feels at home in his clique. The escalation of conflicts, particularly at school where he has a stable relationship, led to the introduction of external helpers and to the confrontation of the parents with the fact that they have to find a tenable solution for David.
Activities
Establish contact via school and collective activities (strengths and own motives were most detectable here) Stabilization via school and by strengthening his contacts in school: conversations with both teacher and David Work with parents and David to figure out where David can live in the future
Open to conversations and conflicts
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4 Making Decisions: Preparing a Contract, Setting Goals, Planning Interventions 4.1 TheContractIstheBasicGuidingPrincipleofSystemicWork
4 Making Decisions: Preparing a Contract, Setting Goals, Planning Interventions
4.1 The Contract Is the Basic Guiding Principle of Systemic Work At the end of the initial phase or initial interview, a contract should be set up between the helper and the client system. This chapter is concerned with the role of the contract in systemic work and how to design such a contract. Contracts form the basis of all cooperation. They contain all the necessary stipulations, goals and duties of the parties concerned. – A contract creates transparency: Both sides know exactly what they must do or refrain from doing. – A contract furthers a sense of security: Both sides know what they are getting themselves into, what is expected of them, what they can expect of others, and what is not the subject matter of the intervention. – A contract establishes commitment: A contract means being mutually obligated to comply with the arranged rules. – A contract sets clear boundaries for the assistance: Whenever we agree on who does what and how we want to reach that goal, it also becomes clear what cannot be expected! This is relevant not only for the initial phase and initial interview, which establish the framework for the entire intervention. Discussing and agreeing on a contract is an essential and continuous work principle of all systemic interventions: – The present problems and concerns of the participants are discussed at the beginning of every session and the further procedure is agreed upon. The parties ensure that the agreements lie within the contractual framework, which may mean that some current (new) problem cannot be discussed because it is not part of the contract or would change the contract. – Within a session the parties can agree to other, smaller contracts for the next step. Case example: In an assisted-living facility for the mentally ill, Ms. Miller helps the female patient B. The two of them have agreed that Ms. B. should learn a different way of dealing with her withdrawal tendencies than simply sitting in her room all the time, failing to join the others in the common rooms and not participating in any recreational activities. This form of withdrawal tends to be the result of conflicts that occur when B. has contact to individuals from outside the facility. In the past, one could observe a pattern: conflict,
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withdrawal, deterioration of mental state, patient enters hospital, patient is discharged from hospital, new outpatient program established with the goal of integration, new conflict etc. Thus, this seemed to be a reasonable contract goal for the assisted-living facility. In the session Ms. Miller notices that the patient is hardly paying attention and is apparently lost in her thoughts. She mentions this and points out that they had agreed the last time to discuss the course of the patient’s contacts with others over the past week and to plan things for the next few days. Yet this is not possible if the patient does not pay attention. Ms. B. agrees. She says she has been thinking of her grown daughter who rejects any contact with her. Ms. Miller suggests talking about this matter for 30 minutes and considering whether Ms. B. could somehow plan her contacts with her daughter and with her entire family differently in the future. Ms. B. agrees but doesn’t want to talk at all about the last fight she had with her daughter. That would stir up too many bad feelings in her. Ms. Miller accepts this and says that she will take care not to discuss the feelings connected with that fight. She asks whether the patient will agree to the suggestion of setting up all the persons involved in the form of little figures on the table (the daughter, the daughter’s husband, their two children, the patient’s father and mother, the parents of her son-in-law, etc.). The patient agrees and the two begin the session.
This example shows how discussing and agreeing on a contract becomes an integral part of systemic work. There is the contract for the entire intervention (support for making and maintaining social contacts), there is the contract for the individual session, and there are contracts concerning the next steps in the overall course of the session (exploring the family context by means of symbolic figures). This discussion also includes clarifying what the patient did not want to talk about, namely, her feelings emerging from the last fight with her daughter. This agreement clearly delineates the scope of the conversation for both sides.
Background Text: Why Do Systemic Therapists Speak of Contracts and Concerns? If you want to make a good contribution to a discussion in a team or supervision session of systemic therapists, it is advisable to first ask what the mandate and the contract in the case are. Everyone present will immediately consider this a reasonable and proper contribution: Your goal has been reached. What’s the story behind this almost mandatory ritual in systemic circles? First, a very practical explanation: When we go from a work setting with an individual client to working with an entire system, we meet with the following problems: – The concerns of the individual members will not always be identical – and these differences can be very explosive. – If we fail to explain exactly what will be talked about and what won’t be, the system will suffer and have more problems after the session than before.
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– Especially if other helpers or institutions are involved, the procedure about how information is to be handled must be completely transparent. Within the systemic approach – when compared to individual-oriented therapeutic approaches – we descend more deeply into the overall life situation of the clients in order to achieve change. For this reason, clarifying and determining the framework of the intervention is of utmost importance if the helper and the rest of the system are not to end up in chaos or serious entanglements. And that means checking the mandates and contracts again and again. But there are also some fundamental arguments that support contracts. The systemic approach sees the clients as the true experts on their life (Rotthaus, 1989; De Jong & Berg, 2012, p. 46, 284 ff.). The relationship should be a cooperative one, where everyone is on the same level and the resources and competence of each partner are respected. This philosophy may also be found in the formal part of the helper-client relationship: negotiations and agreements are carried out in an open and transparent way. Steve de Shazer (1985) introduced the term “customer” into systemic thought – the informed customer one might say (Hargens, 1989). Jochen Schweitzer (1995) suggested the idea of “customer care as the service philosophy of systemics.” But customer care also means that we, as contractors, have to be concerned with determining our customers’ needs and what they are demanding of us. If our offer fits the bill, then a contract is the next step. This attitude can, with some modifications, also be applied when we are in a supervisory role, where it is also worthwhile to work closely with the clients to make the premises and course of one’s actions transparent and to agree with them on one’s own leeway (s. Chapter 4.1.6). From Steve de Shazer’s (1985) differentiation of the three types of relationships we can have with clients we can deduce additional, quire pragmatic reasons for making contracts. De Shazer differentiates the following types of clients: a) Customers who want to change something and are willing to invest in this effort. b) Claimants who want someone to listen to their story in order to complain about it. c) Visitors or draftees who were sent by others and have no inherent reason to be there. If you want to work a lot and achieve little, treat these three categories the same. Everyone else should note carefully who the client is and adapt the contract offers accordingly (see also Chapters 4.1.4 and 4.1.5).
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4.1.1 How to Set up a Contract Contracts for a specific intervention, for a session or for the next step of a session cannot be made at the beginning of an encounter with a client system – too much preliminary work is necessary for that: – As with the initial interview, one must first establish a good basis for working together, consisting of good contact between the parties and an atmosphere of trust. It is important to establish a personal connectiveness in each and every meeting. – The present issues and the motivations of those involved need to be thoroughly explored. Who wants what and why? What is that person ready to do (or not to do) to this end? – The helper must also know what he or she can offer the system. This offer must be formulated by taking the institutional contract and professional demands into account (see Chapter 4.1.8). Only now can the concerns of the client system and the stipulations of the helper be negotiated into a single agreement. We are dealing here with many individual steps that both impatient clients (and counselors) have to take – a difficult mission especially when both sides are under intense pressure to get the help flowing. The clients often feel pressured to solve the problem as quickly as possible because they are suffering tremendously or fear serious consequences. The counselor is often under institutional pressure to offer adequate help quickly in order to secure his or her facility’s welfare. But others, too, particularly those transferring the clients or footing the bill, can exert pressure to act. Nevertheless, it is not wise to work without a solidly developed contract. Of course, there are situations where “first aid” is demanded and should be given; contracts are then added later. Or perhaps one starts by defining only the exploration phase and agreeing to close the contract later. Sometimes clients are so moved or so excited at the beginning of a session that the counselor must first simply try to soothe and reassure them before negotiating what should happen during the session.
4.1.2 What Does a Contract Contain? Contracts usually have four aspects to them: – Goals: Where are we headed? – Tasks: Who controls, who brakes, who looks at the map? – Setting: Who’s coming along, whose car are we taking, when do we get back? – Information management: Who sends whom a greeting card? Goals What is the goal of the entire intervention, the next session, the next step? The mandates presented by the client system to the helper system form the basis of
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such decisions. That is why it is important to first talk about issues and mandates before deciding on goals. The art of a good dialog about mandates and goals lies in advancing from general and imprecise goals to more exact goals (see Chapter 4.4). Vague goals such as “improving overall communication” or “supporting and consolidating the partner relationship” do not suffice for a work contract; they can, at best, indicate the general direction the work should take and thus be a starting point for further concrete steps. For this dialog, the solution-oriented questions formulated by Steve de Shazer can be very helpful: They invite the clients to describe their lives without the problem or symptom (see Chapter 5.3.2). It is also important to flesh out the goals very concretely so that we don’t cheat ourselves or the clients out of the successes. Only when the goals are concrete and observable do we know when we have truly reached them and can rejoice at their completion. Such a dialog is also useful for discerning realistic and unrealistic goals. Case example: A couple had just lost custody of their child, and the child had been placed in a foster home. Their mandate was to get their child back. This may be unrealistic and should not be made the goal of the intervention. Likewise, a couple’s mandate to help them get over the loss of their child from an accident as quickly as possible is not realistic. In both cases helping the couples with their normal mourning reactions could be a realistic goal, inasmuch as they are willing to go that route.
Thus, the task is not only to see what sort of mandates the clients have, but also to see which meaningful and realistic goal helpers can offer clients based on their professional competence and experience. That means checking whether the goal lies within the conceptional framework of the helper, the institution or the organization paying the bill. Tasks Once the goals have been established, it is clear where we are headed. Now is the time to determine who will be in the driver’s seat – otherwise disappointment and anger will inevitably arise among the traveling party. This is especially true of large helper systems with many different involved institutions. Above all, the following should be clarified: – Who does what and who does not (actions)? – Who is responsible for what and who is not (responsibility and accountability)? In an inpatient facility for children, the problem arises as to how the responsibility is to be divided among the Youth Welfare Office, the facility itself, the child’s therapist, the mother, the mother’s legal guardian, and the child’s grandparents. In very complex helper systems it is not always 100% clear to the involved helpers which tasks the others have and what cannot be expected of them. Especially clients who have little formal knowledge of how institutional support works may quickly lose track of which institution is in charge of what. This latter point is important for a successful cooperation and for the overall success of a complex system. But it is also the case even in relatively simple helper systems. Clients
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intuitively have expectations about what helpers do and what they are responsible for: – What can a client realistically expect from institutional family-welfare counseling? Will they come and clean the house or raise the kids? They probably will. – What can one expect from debt-management counseling? Do they pay the bills, balance the checkbook, write letters to the creditors and take care of everything else for that matter – that would be very practical! – What can one expect from child guidance counseling? They’ll surely tell the daughter to stop behaving in that way and to listen to her parents more. – Counseling, on the other hand, is real easy – all you have to do is go there once a week and spill your guts. That’s good because all your friends run away when you even mention the topic. And of course you can call your counselor any time you want in between. There is a good chance that these intuitive expectations of the clients do not necessarily agree with those of the helpers. And perhaps the expectations the helpers harbor for the clients are also unknown to the clients: – The life counselor may expect of a client that the client try out something new to relieve or resolve the suffering. – The educational counselor may expect that the parents of adolescents also be willing to deal with their own problems and with their relationship with their child, to question themselves and to try out something new. – Debt counselors may assume that they will give some clients only a few suggestions, and that clients will be able to watch out for their own accounts and deal directly with the bank and creditors. A good contract thus clarifies the following: – what help is to be offered and not; – the limits of support and assistance; – mutual expectations and obligations. Clients should have a realistic idea of what the actual assistance will look like; their own commitment should also be concretely spelled out. Setting By setting we mean the entire external framework of the intervention: – For which period of time will we be working together? – How long will the individual sessions last and how often will they take place? – Where will we meet and what will be the rules of these meetings? If the meetings are to take place at the clients’ residence, it is important to ensure that the setting will be sufficiently undisturbed. – Where will the evaluation take place? Who will be present? Clarifying this point is especially important if the recipient of the service and the person paying for it are not one and the same.
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Information management Questions pertaining to this area tend to get overlooked, though they are of major importance in more complex helper systems: – Who reports to whom and in what form? – Does the client system receive notice of such reports? Does it see the actual content of the reports? – What effect will such a report have on the client system? – What special occurrences must be reported by the helper? – Who coordinates the helper system? Who is responsible for ensuring that information is passed on to the other helpers involved? Does someone have overall control of the project – is there a case manager for all supporting measures? These questions are of particular importance when social control is part of the mandate – and when clients would suffer severe disadvantages if the information were to be passed on: – In probation counseling it must be clear how the probation helper is to deal with information received concerning other misdeeds of the client: When must the counselor report things to the court and what are the possible consequences for the client? – In adolescent counseling, should the client’s family know that information concerning abuse (physical or sexual) has been passed on and what are the consequences thereof?
Background Text: Noncompliance with the Contract The Power of the Counselor and the Independence of the Client* What it means when contracts are unclear or not adhered to becomes obvious when we think about concrete situations experienced with clients. Imagine, for example, a family going to a family-counseling center for a session scheduled to last 1 hour. Yet the counselor doesn’t stop after the prearranged period of time, apparently thinking that something is so important that it has to be discussed at greater length. The family, of course, wonders: “Is this going to last another 15 or 20 or 30 minutes? Will I miss some other appointment because of this delay? Well, he’s the specialist, he ought to know what’s best! But should I contribute to what is being said or will that bother the others since we’re already over the time?” As a client I am at the mercy of the counselor, unless I possess sufficient social competence to can say to the counselor (without endangering our relationship) that I am no longer able to concentrate on the conversation because I’m so unsure of the timeframe.
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The counselor does have a certain measure of power over the client system in the situation described, especially when moderating the session and not keeping to the time schedule as agreed upon. The client system becomes dependent if we assume that many clients in fact do not possess the social competence to actively step in as described. Everyone has experienced such situations in group, team or business meetings when the boss or group/team leader overruns their time without an agreement in place on how long the meeting will go on. In such situations helpers may be acting out their (unconscious) needs for power in socially acceptable ways. After all, they are the “good guys” who are sacrificing their valuable time to take care of this important client. Similar dynamics may also be found with respect to the strict observance of the content of contracts. Let’s turn to the role of the client system. So we are in counseling because our adolescent son is acting up, not listening to us and doing poorly in school. We are sitting together with the counselor and he keeps asking us how I and my wife are getting along, whether we do things as a couple, when the last time was we were out on the town, etc. – the only thing missing would be his asking about our sexual practices! It would be a different matter altogether if he were to say that he first wants to talk to us about how my wife and I cooperate at being good parents in order help us do a better job. If he’d just explain shortly what he’s doing then we could say yes or no. These situations show how a unilateral power position of the counselor – and the corresponding inappropriate dependency of the client – arises when the contract is unclear or nonbinding. The same is true when the helper fails to observe (or interprets freely to his advantage) other parts of the contract, e.g., particular goals or the handling of information. But it is exactly this type of action that contradicts the basic tenet of cooperation in systemic thought. *The ideas described here stem from Antony Williams (Australia), who analyzed the dependence of group participants when group leaders exceeded time limits during a seminar he gave in the summer of 2003 in Hohe Tanne (Switzerland).
4.1.3 System Politics: Open, Hidden, Contradictory and Ambivalent Mandates Social systems always represent a web of interests and thus always have a political dimension to them. There may be differing, even contradictory interests, some of which are laid open, others kept hidden. That is all part of the complexity of social systems. For helpers this means being alert to the type of mandates the system approaches them with. Below we discuss some of the various forms of mandates and give some advice for proper communication in the respective situation.
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Open Mandates This is where the clients openly and clearly state what they expect: “I want to get rid of my debts! Help me please!” Here the best route is to – repeat what one has understood as the mandate in one’s own words – and let the client confirm what has been said (active listening); – query the client exactly about what is being expected: “How exactly would you notice if the job had been done?” Don’t settle for generalizations! – determine exactly how the client wants your support. Ambivalent Mandates The mandate is open and clear, but the client refuses to take certain steps necessary to reach that goal. Case example: A client may think as follows: “Well, I would like to get rid of my debts, but I definitely do not want to deal with all those unopened letters from creditors lying in the drawer. And I don’t really believe in keeping records of household spending. And I sure don’t want to sell my (expensive) car!”
On the one hand, the mandate demands of the helper to bring about change. On the other hand, everything should be left as it was, Change can be unpleasant and comes at a cost, which may appear so high as not to be worth it. Sometimes the desire not to change – to keep everything as it is – is not immediately clear to the client; or the client notices it later in the midst of the intervention, when the time has come to actually carry out the planned resolutions or do one’s homework. The following has proved useful: – Give clients the room to explore their wish to maintain the status quo and discuss with them the potential costs of change. – Suggest to the clients that you, as their counselor, think the mandate is problematic, and that you don’t want to take it on right away – that it is important to think through together all the advantages and disadvantages before turning to the matter of actual change. – Warn the clients about going at things too quickly and too radically because the results can be negative if implemented too rapidly. With ambivalent mandates, the goal is to provide sufficient room for doing nothing and for thinking about the potential negative consequences of change – to do that side of the ambivalence justice, too. This type of intervention was called by Selvini-Palazzoli and coworkers (2013) “paradoxical intervention” (see Chapter 5.4.4). Hidden or Secret Mandates Some members of the system may expect that the helper will change or stop certain developments or problems which the system cannot even properly label. Besides the explicit, official mandate there may thus be implicit, unofficial, secret
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mandates that unfold only during the course of the intervention and have a great effect. Case example: In couples’ counseling, the hidden mandate of the husband may be: “My wife’s tendency to be a neat freak really gets to me. That is the true problem, and I certainly hope the counselor sees it and can get her to stop being like that.” The open mandate, on the other hand, is: “Our communication is poor, and we want to improve it.”
Not always does one part of the system have a different hidden mandate toward the other part of the system, as in this example; a family may have a common but hidden mandate toward the helper: Case example: A nursery school sends a family to counseling because the caretakers are skeptical about the development of the child as well as about the family’s overall ability to care for the child. The family comes to counseling and presents itself as trouble-free but highly motivated. So the hidden mandate may lie in the helper attesting to the family that they are cooperative and motivated and have no real problems. The nursery school is pacified, and the family has one less conflict to deal with.
Hidden or concealed mandates may stem from other helpers in the system: Case example: Social Services ask a Family Counseling Center to work with a family to improve the educational capabilities of the parents. In fact, however, Social Services want the center to check whether the children are being neglected, mistreated or abused in any way. They hope to then be in a better position to judge whether the children’s welfare is endangered, and to possess sufficient evidence if the whole matter lands before a court.
Hidden or concealed mandates may also be discovered in the gap that lies between what is expressly said and what is actually meant – the message between the lines. We can often surmise such mandates via our emotional or even physical reactions. Often they emerge only during the course of an intervention. But we must differentiate: The mandates may be ambivalent but those involved are not – they always know exactly what they want! Case example: The wife from the above-mentioned couples’ counseling does not, in fact, want to be “cured” of her knack for cleanliness. She just wants her husband to help keep the place clean and in order. She’s not ambivalent at all – it’s her husband who is disturbing her notions of orderliness. He’s the one who can no longer live with it – which means he’s not ambivalent either.
Further below we look at contradictory mandates. If the husband and the wife were to clearly vocalize their respective mandates, we would have a state of contradictory mandates. The exceptional thing here is that both “officially” claim to have a very different mandate formulated rather neutrally: “We attend counseling to learn to communicate better and to have fewer spats.” In this respect, the following has proved useful: – As counselor, keep your distance to the various clients in order to first resolve your own feelings about the case, so as to keep your flexibility in the midst of such a complicated system. – Openly question the clients about suspected hidden or concealed mandates.
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Sometimes you may even have to be forceful or a little bold by directly mentioning what you are feeling. At the same time, respect is necessary in order to know exactly when and how to bring up the topic. – If the hidden mandate is revealed, ask the other participants whether they agree to work on this matter. Give space to all positions and see to it that they can exist side by side, even if there is no immediate solution. – Finally, discuss with the participants which of the common mandates and goals can be agreed upon. We suggest that the counselor not just take on such mandates, but rather work closely with the clients to turn the hidden mandates and the discrepancies toward the official mandates into matters of general discussion. This may even make an open and official mandate out of a hidden and unofficial one. Thus, we often avoid doing some real conflict management. But that will increase the chance of successful cooperation with and among the clients. Simply taking on hidden mandates restricts the counselor’s freedom considerably. Hidden and concealed mandates give us the chance to avoid lunging headfirst into coalitions with parts of the system. Background Text: In Praise of Hidden Mandates; or: How to Slowly Melt an Iceberg Proper clarification of the mandate considerably increases the chance of success – it is worth one’s while to take the time and effort to see it through. This is why so many systemic theorists are such great fans of “clear mandates.” Yet life is not always that tidy – sometimes we have to fish in muddy waters, and suddenly we discover that things keep getting muddier the more we stir them up. If we just let everything sit for a while, clarity will return. So let’s pay tribute to hidden mandates and do it systemically: with respect and with an eye toward finding significance in such a dastard act. The following comes to light: a) “Being open toward all sides may lead to drowning.” Clients who are completely open and honest from the beginning about why they are there may go under. They don’t yet know whether they can trust us and what they are getting into. b) That is especially true when the matters of discussion (whether open or hidden) are delicate, intimate, taboo or shameful. c) Sometimes clients don’t know at the beginning what the whole thing is about and discover it for themselves only in the course of the intervention. Case example: During conflict counseling for a team from a church organization for the handicapped, we received the mandate to settle an escalating conflict between the director of the organization and the board of the sponsoring church. The board had
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strongly criticized the director, and a number of alarming incidents seemed to support their claims. The mandate was outlined very precisely and contracted clearly. All participants, including the counselors, put great effort into finding solutions. After four months’ time, however, we had the feeling that the board wasn’t really interested in clearing up the matter, but rather in getting rid of the director. After a while this was even expressly admitted and subsequently carried out. What then came out into the open seemed to warrant the drastic measure – in our eyes, too. An evaluation session revealed that the board knew from the very beginning that there was no alternative to firing the director.
This is a good example of a hidden mandate; and it turned out to have been of the utmost importance that we so trustworthily (and trustingly) carried out the official mandate. The director (who, like us, was not privy to the hidden mandate) had learned to trust us during the course of the many sessions – even in light of his impending suspension. For personal reasons he felt very attached to the organization, but was obviously completely overwhelmed by the demands made of him, especially in difficult economic times. To have to leave the organization was the worst possible personal tragedy he could have imagined, and he reacted with depression and suicidal tendencies. And had he gone through with it, it would have been the greatest possible tragedy for the organization and for the church sponsor. Our attempts as counselors at finding a solution to the problem created the foundation of trust that eventually helped us, upon his being fired, to counsel him in his anger, feelings of failure and sadness and to prevent his attempting suicide as well as to guide him toward a new orientation in life. This example shows, among other things, that we should not be completely critical of hidden mandates, but sometimes accept them as an important means of protection – as the wisdom of the system. We should believe more in the process of building up trust, which in the course of an intervention allows us to then name and deal with difficult and tabooed matters as well as with hidden or “bad” motives. Bernhard Trenkle used the so-called iceberg metaphor (1994, personal communication): He trusts that the iceberg will slowly rise up, and that the hidden parts of the iceberg underneath the surface of the water will rise more quickly the faster one melts those parts above the water surface: The iceberg becomes lighter. We would add: It is sometimes impossible and undesirable to try to measure the entire length and breadth of the hidden part of the iceberg before beginning with the melting work. Rather, it is better to work honestly with the visible part. But you have to be careful and always keep in mind that there are still many important things to discover, and that these may (or may not) become visible in due time.
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Contradictory Mandates Various members of the system may have mandates that contradict each other. These are not necessarily hidden or secret mandates, but rather can be contradictory mandates that are out in the open for all to see: Case example: “My husband is so hard on the kids and doesn’t take care of them enough. Please make this clear to him and help him to change his ways.” – “My wife is simply too permissive and overprotective. Please help me to get her to grow up. She just won’t listen to me.”
This is the sort of mandate that begins with a clear conflict. As counselors we should see to it that the contradictory mandates are put on the table, and that enough time and effort are invested in solving this conflict as the first step in the counseling process. Several Different Mandates Various members of the system have varying mandates that are different but not necessarily contradictory, nor are they hidden or secret in any way: Case example: “We have a problem keeping our finances straight.” – “Our problem is that my husband can’t find a job.”
The best thing here would be to collect the various mandates, problems and resources into one pot and then decide – which mandates are realistic and which are unrealistic, – which helper can best offer what help, – who does what, – in what order the mandates are to be worked on. Resolving these matters is the prerequisite to avoiding endless rounds of support sessions and unrealistic expectations among the members of the client-helper system.
4.1.4 Complaining Clients: Listening as Mandate Up until now we have mainly followed de Shazer’s (1985) terminology of “customer relations.” We have spoken of clients who articulate wishes, have the necessary motivation to work together with the counselor, and (more or less) seize the incentives and support offered. Since most psychosocial professionals have been trained to stimulate change and personal development in their clients – and see that as their primary mission – this type of work can be very satisfying and successful. It can become frustrating, however, when clients can clearly describe their problems (sometimes lots of problems), but declare all attempts at effecting change to be unrealistic; or when clients show behaviors that clearly demonstrate that the suggested solutions will never come to be. Steve de Shazer called this
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type of person the “complainer.” Note that we are still talking about types of interactions, malleable typologies of relationships – not about individual personality traits. How does one recognize such situations? – Concrete problems are brought forth, but no plausible goals are formulated. Plausible, in this context, means: The client does not (or cannot) contribute anything to the attainment of the goals. – The client describes him/herself as a victim, at the mercy of some circumstance(s) or malevolent people, with no possibility of changing anything for the better. This type has two variants: Some refuse all possibilities for change during the sessions. For helpers, this offers a rare chance to touch up on their knowledge of “killer phrases”: “Oh, I’ve tried that already . . .” “That won’t work because . . .” “I don’t think you really understood what I meant, otherwise you wouldn’t suggest such a thing . . .” The better behaved clients will thank you after the session for the interesting conversation and promise to honor your suggestions. In the next session, you can expand your repertoire of excuses, while listening to countless reasons as to why it didn’t work out: “I tried, I really did, but . . .” – Either no concrete mandate is given or the mandates are impossible to fulfill (e.g., changing other people or changing structural circumstances). The trap we helpers frequently fall into is putting even more effort into the affair by assuming the responsibility for finding solutions and then actually thinking up ever better, ever more realistic ones. This results from the subtle dynamics helpers are apparently susceptible to: assuming the client’s responsibility for change and taking more and more of the steps necessary to effect such change. This makes the client even more passive and regressive, and it neglects the client’s resources – while the helper becomes ever more active, intensely searching for solutions. Incipient feelings of anger on the part of the helper are held in check by a well-practiced agency of self-esteem: “I’m not yet good enough to truly help this person.” If you suspect that these descriptions might fit one of your interventions, you should quickly extricate yourself from this dynamic. This becomes easier when we – begin by simply listening to the client without offering or working out solutions on our own; – acknowledge the client’s difficult situation and express our understanding for how tough it must be; – introduce the possibility that the critical situation won’t be resolved quickly, and that, based on your past experience, helpers have not been able to bring about a significant improvement; – take up the cause of “no change” and ask how the client would adapt to such a possibility: “Now that it has become clear that changing your situation will be difficult if not impossible, how can I help you to endure this and still stay healthy?” – ask the miracle question: “If, by chance, a miracle were to happen overnight and
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all these things were no longer a problem, how would you notice it – what would have changed for you, what could you do then that you can’t do right now?” (see Chapter 5.3.2) – lend a sympathetic ear: “Maybe what I can best offer you is that you come to me once a week for half an hour and just let it all out. I’ll simply listen to you for that time.” How do complainers interpret such offers? We would like to offer three hypotheses and show how the suggested method can work: – Clients are highly ambivalent toward the idea of change. Here the same is true as in the section concerning ambivalent mandates. The paradoxical emphasis on “no change” helps the clients to take a hard look at the realistic possibility that everything will indeed stay the same – whereupon they can develop some sort of motivation to change or to find a way to live with the status quo. – Clients want change, but they also want the helper(s) to become actively involved, even if they themselves don’t want to raise a finger (or at least believe they don’t have to). Here, too, the helper should decline assuming responsibility as described above and clearly show the clients that they must become active. This can be successful, especially if coupled with questions concerning how the clients envision future solutions and compliments about previous small steps. – Life is full of situations that are difficult and sometimes almost impossible to change. The offer to simply listen may, in fact, be sufficient. Not everything can be modified to one’s complete satisfaction, and empathy can sometimes help others to “suck it up” when there are no good alternatives. Of course, the joint search for what little relief there may be should be continued. In any case we should try to determine where the possibilities and motivations for change lie – and use them once found. On the other hand, we should completely respect the decision of a client or a system not to change (or not to want to change). Case example: A 68-year-old woman is in a very unhappy relationship. Her busy husband fails to pay much attention to her and takes advantage of her. There are also other conflicts in the family. The idea of leaving her husband or at least talking to him about her problems appears to be unthinkable for her. First, she doesn’t really want to leave her familiar surroundings (home, children, grandchildren); her value system and her self-image wouldn’t allow such a drastic step. Second, her husband, apparently, is unaware of any problems and is unable to accept criticism or change his ways. In counseling the woman learns to set clear boundaries, to better ward off his impertinences and to gain more space for herself. Her husband also seems to react to the changes in her attitude – he’s become more open, she thinks. The situation has become relatively acceptable to her. Still, many of the burdens remain, and there is no real change in sight. She complains to the counselor, who is perplexed about what to do now –regarding the matter of change, that is. It appears to help her and relieve her woes when they talk about things and she is offered a sympathetic ear. She still comes to counseling irregularly, still complains, but now it is clear that there is no pressure to change. Smaller impulses to expand her network of friends or make time for positive experiences in her life seem to help her to cope.
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4.1.5 Draftees: When Others Are More Motivated than the Clients Counselors in psychosocial services are often confronted with clients who have been sent to counseling by someone else (sometimes under great pressure): A family is sent by Youth Services to a family counseling center; an alcoholic mother has to attend addiction counseling to keep her visiting rights with her children; a court orders someone to get anger therapy; a convict has to cooperate with his probation officer; a school sends parents to family counseling (Figure 20).
Figure 20: Clients sent by others often go to counseling because of pressure from a third party
The third party involved always has great interest in the course and results of counseling – often more so than the clients themselves. Such “draftees” tend to approach counseling accordingly: – They are openly defiant, stubborn, and are present at the session only the physical sense: “I don’t know what I am doing here, so ask your questions . . .” – They attribute their problems to external sources, oftentimes the organization or person who sent them: “At home, he’s always so well behaved. But the teacher at school apparently can’t handle such active children.” – The following is true in all variants: No concrete problems are mentioned, no goals brought forth, no mandates desired. – The counselor and the client have very different goals. – Yet it is also possible that such clients can in fact learn to appreciate the offers made and take the counselor up on them – knowing, of course, that they effectively have no choice and need to cooperate to avoid getting into trouble with the organization or person who sent them. Case example: Mr. Snare, already convicted of fraud and now confronted with new accusations, is sentenced by the court to a forensic clinic for therapy. The prosecutor says he would consider waiving an arrest, suspending the execution of the warrant of arrest, and the probation officer is agreed. The therapist pays careful attention to whether the man is only superficially complying with therapy and takes considerable time setting up the contract by pointing out the compulsory nature of the intervention – all of this by the book. The client does the same: At first rather reluctant, he takes his time telling his story; but then he recounts truly emotional situations and implements the therapist’s suggestions (in moderation, not everything and not all at once). So he’s being very cooperative. The therapist becomes skeptical only when both the first and the second invoice go unpaid. A call
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to the client’s insurance company (with the client’s consent, of course) reveals that both invoices had been submitted and in fact already paid out to Mr. Schlinge. (With his type of insurance policy, the client first sends in the invoice, part of which is paid out directly to him, and then pays the therapist’s bill in full.) A call to the client by the therapist causes the client to terminate the therapy. Further attempts to contact the client go unanswered; collection agencies are unsuccessful as is subsequent litigation. About a year later the probation officer says to the therapist, in an attempt to console him: “If it’s any consolation, the prosecutor was also duped, and the case had to be abandoned.” The therapist, a 20-year veteran (with a number of compulsory cases) chalks it up to experience.
Even if we keep in the back of our minds that some clients are more scheming than counselors could ever imagine, we should remember some basic things when dealing with such cases, which will at least raise the probability of success: – Discuss expressly the pressure being applied by external parties (see Cohen, 1999): “What could we do, and what should we do, to satisfy the people who sent you here? To force them to let up, pull back and give you more room to decide for yourself? Is that a goal you’d consider worth fighting for? How far would you go? What would we have to change to get rid of me as soon as possible?” – Discuss openly with the client the motives, interests, intentions and ideas of whoever sent the client and see where they correspond with those of the client. The questions listed in Chapter 2 concerning the transferring of clients may be helpful here. – Talk about the forced nature of the situation; show sympathy for the client’s anger and displeasure. Who wouldn’t feel this way in such a situation? – Address the client’s resources and strengths, respect his free will and discuss the consequences of his decisions. In doing so, we make clients aware of their responsibility for their own behavior: “I do not want to do anything against your will, but let’s think about how the court would react if the desired changes do not come about.” – Whenever possible, hold joint contract discussions between the person or institution sending the client, the client and yourself as counselor, much as is routinely done nowadays in youth welfare services (assistance planning conferences). These meetings should deal with responsibilities, information flow and cooperative arrangements. For example, when a school is the one sending the client, it has proved advantageous that meetings be held with teachers, parents, the child in question and the counselor in order to interrupt the game of mutual accusations and prevent a triangulation of the counselor. Once a good cooperation has been established, one of the main factors keeping the problem alive is weakened or disappears: With behavioral problems in school, children often take the negative comments of their parents about teachers (whether openly or secretly expressed) to be implicit approval of their own disruptive actions. A broad cooperation (e.g., rapid information exchange, weekly telephone conversations) stops this pattern and often suffices to bring about positive behavioral changes.
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Of course, in all these instances we are dealing with the themes of control, obedience and autonomy. Draftees are always worried that it will have negative consequences for their children if they as parents don’t do what the “experts” suggest they do, which in turn can lead to apparent conformity and superficial cooperation. Establishing the mandate can make the draftee feel restricted in his or her decision-making authority or unable to decide completely freely. The theme could then be: How can one regain the competence to make one’s own decisions – including the ability to freely decide pro or contra professional help? How can I, as counselor, be supportive?
4.1.6 Control as Mandate: When Counselors Must Be More Motivated Than Their Clients The systemic tradition, as it was originally intended, was a form of psychotherapy far removed from concepts such as coercion and control. The basic tenets of systemic thought – respect for the autonomy of the clients and the conviction that systems are not teachable, not consciously controllable – don’t exactly encourage its transfer into contexts of external constraint. Thus, initially a sharp line was drawn between therapy and social control (Figure 21). Nowadays, however, many users of systemic principles stem from institutions charged with duties involving control: youth welfare services, psychiatric clinics, inpatient adolescent wards, (juvenile) prisons, probation services. For this reason, we address the issue of compatibility of coercion and systemic concepts for a number of fields of work. Our own experiences with youth services, having closely cooperated with the social services of the youth welfare offices, have opened our eyes to how the coupling of pressure and support can in fact instigate developmental processes that would not have been otherwise possible in a classical counseling context. Many families from social fringe groups have great dif-
Figure 21: In some control mandates, the clients are forced to submit to support measures because of legal regulations that restrict their free choice; the institution providing the assistance then has a control function
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ficulty with the classic therapeutic setting and either fail to even come to the first session or soon break off the therapy. Experiences in the United States combining coercion and therapy were also very helpful: Cloé Madanes, for example, reported at several congresses on her experiences in therapy projects for persons convicted of incest, all of which were closely enmeshed with the justice system. In principle, we are dealing with a triadic structure similar to that discussed in the previous section, albeit one in which the third party doing the referring is a virtual partner. To be effective and successful in this situation, you must be completely clear about the role you are assuming: Someone is demanding that you provide support and aid, while at the same time controlling, confronting and challenging the clients. This also means being confident enough in one’s own abilities to stick to the unpopular side of exercising power. By the way: If we succeed in bridging this split personality, this is no different from what millions of parents do every day, namely, combine a portion of partisanship with a portion of limit-setting power politics – in a ping-pong formation of constant role-switching. But limits also imply support, and that is exactly what many clients from marginalized social groups have rarely experienced in their lifetime. The following suggestions have proved useful when discussing the projected mandate with the client: – Make everything completely transparent, i.e., make the prerequisites of one’s own behavior very clear. Declare unambiguously when the counselor has to act against the will of the client: “As your family counselor I will treat all information I received confidentially; I will let you know what I tell the authorities, and you can read all of my reports. But if I see any signs of violence or abuse in or on your son, I will – even against your will – notify the Youth Welfare Office.” – Show sympathy for sometimes very radical and provocative behavior on the clients’ part – while also making clear that this type of behavior will have to be reined in. And if we fail to create acceptance and understanding on the part of the clients for the role of the counselor, then we must to stand by our position without their approval: “Your extreme resistance tells me how much you love your daughter and would like to live together with her. I can understand that – if it were to happen to me, I would probably act similarly. But we can’t have that here and that is not the path to take if you want to have contact with your daughter again.” – Show where the limits of your willingness and ability to compromise lie and invite the clients to use the whole breadth of that (albeit limited) space to shape the future. A counselor in the parole counseling office could explain to a man who has repeatedly become aggressive toward his wife and children: “I know that you have the wish to be a good father to your children and to be loved by them – just as you’d like to be a good, strong and loving husband to your wife. I want to help you to show these sides to your family in everyday life. However, if you continue to resort to old patterns and use violence, then I will intervene and set hard and fast limits – limits that will be very unpleasant to you.”
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– Show the clients future perspectives and explain to them how they can be helped. – Suffer through the hard times in which the clients are constantly belligerent toward you. Even while defending yourself and others by applying necessary limits and self-protective defenses, always be prepared to offer your support. – Acknowledge every single bit of cooperative behavior on the part of the clients as a special achievement and thank them for the good teamwork. Case example: Mr. Good is a social worker in a Social Services Office of the Youth Welfare Office. He always tries to help and to solve conflicts consensually. Today he comes to supervision with the case of a girl with health problems whose single mother squanders the money they receive for her daughter’s medical attention. There is mounting pressure among the authorities to withdraw custody. The case discussion reveals that the mother receives an optional payment from the Welfare Agency (situated in the same building), which, albeit small, is quite important to her. The supervising therapist, Ms. Goodhardt, is able to convince the others that pressure can sometimes set things in motion: They prepare a new strategy together with the Social Services Office, to the effect that every Friday the mother is to present Mr. Good with a confirmation by the child’s pediatrician that an examination has taken place that week. Mr. Good then lets the Welfare Office know that the payment can be made. The mother is told that this is her last chance to retain custody of the daughter, seeing that the medical care is essential to the child’s physical welfare. The mother is upset and rants about this vicious blackmail. Every Friday she makes a scene, yet the scheme seems to be working: She takes her daughter to the pediatrician regularly and promptly delivers the confirmation to the authorities. Every time she comes, a short conversation ensues that is used to acknowledge that the mother is acting very responsibly. After 6 months, the arrangement works even without any external pressure. The mother has even thanked the social worker for his rigor without which she would not have “woken up.” After all, she really does want her daughter to get well and is proud of the fact that she is the one who is seeing to it.
4.1.7 A Method for Resolving the Mandate Matter: The Carousel Anyone who is a little dizzy at the many possible types of mandates should take a closer look at the carousel method. As always, whenever complexity becomes overwhelming, it is helpful to imagine things figuratively, or spatially. The mandate carousel was invented by Arist von Schlippe and Jürgen Kriz (1996), originally as one of several means of self-supervision. We use the method especially with female clients in complex situations. The mandates of these clients as well as other interested parties are written on separate pieces of paper and put on chairs in the room. This provides a sort of mandate sculpture that allows us to organize them and to decide which to pursue and which to politely refuse. Walking around the room furthers communication about the mandates; the movement brings a sort of plasticity to things, and the feeling of being overwhelmed recedes into the background to the benefit of an overview and understanding. Finally, the playful atmosphere lends the entire exercise a light-hearted feeling. Other variants are implicit, presumed, secret, inner mandates symbolized by figures spread out
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in the room or placed on the table (see Chapter 5.1, where we discuss spatial-visualizing methods at length).
4.1.8 Does the Mandate Match the Offer? Despite our concentrating on the needs of the clients, there are sometimes mandates that we must reject. When concluding a contract, the helper must critically check whether the mandate can be meaningfully fulfilled or not. There may be objective or subjective reasons for rejecting a mandate. The subjective ones lie in the nature of the helper – here are some examples: – The helper may feel overwhelmed by the professional necessities of the case or doubt his or her own experience. – The case may reflect the helper’s own biography, which would mean investing considerable time and energy, and limiting his or her sovereignty. – The client may stem from the helper’s own circles; working on the case would disturb that context and perhaps even block proper support efforts because of the social affinity. In such cases we recommend not taking the risk. If possible, do not even make an offer and instead point out alternative routes. The objective reasons for rejecting a mandate can stem from professional aspects or from the helper’s own institutional or social context. Every helper is simultaneously part of one or more systems that in turn is bound by terms and rules. Also a factor is the individual helper’s own benevolence or narcissism: When the hardship of a client touches the helper’s heart, when the client seduces the helper by claiming only you can help – one is sorely tempted to take on a mandate one cannot, in fact, fulfill with a good conscience. In the following, we look at this aspect of contracting from a cognitive point of view, although we know that helpers foolishly take on some mandates not because of ignorance or carelessness, but because helpers are seducible like everyone else. The Impossible Mandate! The helper must always be aware of his or her own professional limits. Case example: A woman asks a counselor about getting couples therapy. She reports that her husband wants to get a divorce and would be willing to go to counseling to talk about matters pertaining to the children. During the initial interview it becomes clear that this is indeed the case. But it also becomes clear that the woman is absolutely not in favor of getting a divorce. First secretly then more openly during the session she wants to talk only about the husband’s reasons for wanting the divorce; he should be motivated to think it over, and the counselor should confront the husband with the ruthless and thoughtless nature of his desire.
Professional experience should tell us that we cannot and should not assume some of the woman’s mandates: Doing so would definitively run contrary to the
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common reason for the counseling, namely, the welfare of the children. We know, too, that systemic counseling possesses no magic potion to convince the husband to stay in the relationship, particularly if that is not his mandate. Case example: A family is having major problems with their 16-year-old daughter. Family counseling is arranged. What the parents want is clear: The counselor should see to it that the daughter stops running around and is back home by her curfew time, does her homework, etc.
Here, too, we are dealing more with the wish for a magic potion than with realistic and professionally feasible concerns. Professionally, we know that the counselor cannot take over raising the daughter in lieu of the parents – and that a few hours of counseling certainly cannot bring about real change. We must be honest with the parents, though we can still offer to work with them to learn how to better set boundaries for the daughter. Often, if a mandate is professionally unrealistic, an open and clear conversation with the client can produce new and different – and perhaps feasible and successful – mandates. The proper know-how and an open and honest style may put the clients in the position to actually find a realistic path to solving their problems. Sometimes it is only a matter of making clear to them what part they have to fulfill in order to bring solutions within reach. Professionalism also means wisely estimating the power of one’s own resources and the resources of the clients, in order to judge whether these are sufficient to meet the bill. A realistic and sensible confrontation is by many lengths better than an undeliberated acceptance of mandates that, besides producing a bad feeling in the pit of your stomach, cannot really be carried through successfully. Our institution says: That doesn’t fit our concept! We recommend informing clients about our own organization’s terms and conditions for interventions. The helper should, of course, check before commencing with an intervention that the contract truly matches the organization’s concept. Case example: In family counseling centers, in child guidance offices, in debt counseling and in retirement homes, one cannot treat extreme drug problems as a sideline. A kindergarten will have bitten off more than it can chew by attempting to help a child with massive behavioral problems. Social services cannot be responsible for tending to a family’s financial chaos.
In such cases, the solution lies in the following: – Clearly delineate all fields of work and abandon the goal of trying to solve everything. – Know which institution is responsible for which emergency situations. – Establish good cooperations and referral contacts with other agencies. One of the greatest difficulties in dissociating oneself lies in the clients’ overwhelming need for personal contact.
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Case examples: (1) In a nursery school a mother repeatedly says that she needs to talk to someone. She has no one else to turn to. (2) A client at a women’s counseling service conveys that she is looking for a friend and not a counselor. She doesn’t really want to change things in her life, she just wants to be able to come once in a while and have contact with a counselor. (3) A mentally ill man refuses to leave his apartment except to buy the absolute necessities; the counselor is the only person he will talk to. And when they talk, he only complains about how awful his life is.
In such situations we must set a long-term limit, since one’s employer will hardly be able to offer such services. Yet, setting such limits can be a very difficult exercise indeed, the only consolation being that avoiding setting limits makes thing even more difficult in the long run: We sacrifice our professional role and identity and slip into a unclear, inconsistent relationship that in the end does not serve the client well. Our institution says: We need the work! This aspect of working for an institutional employer demands much circumspection and ethical involvement. The question is: – Can I afford to say yes? – Can I afford to say no? Institutions have a legitimate interest to survive. When we take on a mandate, this institutional self-interest can play a major role. Case example: A family counseling center or a residential home for the mentally ill is not working to full capacity. The financial plan assumes a certain occupancy rate, and if that is not fulfilled, then jobs, or even the entire facility, will be at risk. When negotiating contracts, public sponsors today will often base their calculations of the per diem or hourly rates for care or counseling on a high capacity utilization. To get the absolute best rates, they allow little or no financial buffers in an institution’s prices. For an employee of such services this can cause a dilemma when negotiating contracts with the clients: There may be little or no professional necessity for the intervention (or no prospect for success), but the contract must be carried out nevertheless.
This demands a value analysis: – Would an intervention in any way endanger the clients, e.g., causing someone to miss work or to become dependent on others for longer than necessary? – Would soliciting internal or external feedback be expedient? – On what level can the dilemma be constructively solved in the long run? Which interventions in one’s own institution or with respect to the state as the contracting entity can facilitate long-term positive development? Ethical considerations, or when society says: No-go! Even when our work means supporting the mentally ill, we can’t just stand by and watch their children be mentally or physically neglected or abused. Here, both as professionals and as citizens, we have the obligation to report such situations to the authorities. Although we are primarily responsible for stabilizing the mentally unstable patients in our care, under certain circumstances we must do something that might, in fact, destabilize them.
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Case example: A client in the process of separating from his girlfriend desires outpatient counseling. There is a clear and serious danger that the client will commit suicide, which may demand preventing his harming himself by reporting it to the police or having him committed to an inpatient facility.
These are situations in which people are acting, or threatening to act, in ways that might endanger their own lives. And sometimes we experience situations in which we become witnesses or at least privy to crimes against others (mistreatment and abuse). Here, the law clearly demands we act not as professionals but as citizens who have the duty to prevent criminal offences or harm to both self and others. Once we alert the authorities to danger, our contact with the system in question may have to be discontinued. 4.2 GeneratingHypothesesandSummarizingaWorkingHypo thesis
4.2 Generating Hypotheses and Summarizing a Working Hypothesis Selvini-Palazzoli, Boscolo, Cecchin and Prata (1981) wrote an article entitled “Hypothesizing – Circularity – Neutrality,” in which they defined the term “hypothesizing” for use in systemic family therapy. This, in turn, had a major influence in shaping the further development of systemic theory and practice. First, they commented on the derivation of the word from the Greek original: “‘what lies below’ or better yet: the plan on which a theoretical construction is based.” According to the Oxford Dictionary, hypothesis means “a supposition or proposed explanation made on the basis of limited evidence as a starting point for further investigation.” This definition describes the use of the word in the experimental sciences. In systemic theory, the term hypothesis is useful because it refers to a preliminary and experimental, process-oriented procedure: We observe, we generate hypotheses and we then intervene on the basis of such hypotheses, learn from the reactions and then expand, supplement, discard or correct our original hypotheses. Thus, hypotheses have two primary functions (see von Schlippe & Schweizer, 2007, p. 117): – They organize the many observations and datasets we have accumulated while working with the clients. They condense individual pieces of information to a single image and differentiate between important and unimportant information. Many authors carry out this process only in writing, which misses the target: Visualizations, like the ones we looked at in the previous chapter (family-helper maps or timelines), actually represent hypotheses or at least help to trigger the process of forming hypotheses. In addition, one can use metaphors, images and symbols while preparing hypotheses – our brains are capable of more than just summarizing written notes into if-then clauses. – They stimulate us to perceive new and alternative perspectives; they are like signposts pointing toward new information and are particularly useful when
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situations in families or systems have become gridlocked and we need a fresh and unconventional approach. Material for hypotheses may be derived from two sources: – From our own knowledge, which we have excised from our own research and experience about specific systems (e.g., co-alcoholic dynamics in addiction systems, acting out by children in structurally weak families); – From our observations of the respective family, person or group – whether through direct contact, through (observed) contact with others or through their interaction with suggested or prescribed tasks and rituals. Employing the first of these two sources in systemic work is a controversial matter. Some solution-oriented therapists suggest always beginning at the point of ignorance and proceeding from there in order to study with fresh eyes the patterns of the system. The trick to forming hypotheses is not to impose one’s professional opinions and conclusions onto a client problem, but rather to always remember that every system is unique, and that we must determine the proper solution from scratch every time (see Background Text in Chapter 4.2.3). Case example: A teacher of dyslexic children in a counseling center solved this dilemma by initially requesting only the name, age and school of the children in his care – resolutely refusing to study in advance any files describing the children or previous treatments. Only after a few weeks’ time, after having formed his own impression of the child, did he meet with colleagues and exchange information about the child’s background and previous therapy attempts. This method proved to have a positive effect on the child-therapist relationship and on the results of the therapy itself.
Background Text: Why Do Systems Theorists Prefer to Speak of Hypotheses and Not of Diagnoses? The systemic-constructivistic tradition says that we cannot assume that we are making objective statements about humans or systems. Heinz von Foerster (2002, p. 154) put it like this: “Objectivity is the illusion that observations can be made without an observer. Appealing to objectivity means refusing to accept responsibility – that’s why it is so popular!” (see Background Text in Chapter 2 on the notion of facts). Objective statements provide us with a sense of security that is a splendid basis for arguing with others about the “truth.” We, however, assume that every statement, such as one about another human being, stems from a human observer. For example, the statement “John is lazy” or “Mary is psychotic” assumes the following: – that we have observed certain behaviors in a social context, – that these behaviors have attracted our attention by somehow deviating form our idea of normal behavior, – that we can evaluate these behaviors according to our own criteria.
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All of this is canceled out in the seemingly objective statement, which has certain consequences as we will see below. First, let us compare (in a rather polarizing way) the treatment and counseling possibilities from the objectivizing and systemic perspective (see Figure 22). According to traditional treatment methods for the problem areas we have been dealing with, the helper (physician, therapist, social worker) is the expert for the problem and for its solution. He or she prescribes or suggests something, and the client does it. The diagnosis represents the objective truth and thus requires great effort; the results have long-term validity. If, for example, schizophrenia is diagnosed, then everyone knows what the next years will bring. If the treatment fails to show success, this will be termed “opposition” by psychotherapeutic circles, ascribed, as such, to the client and his or her mental dynamics. Or one reverts to the diagnosis of “resistance to therapy.” The systemic counselor, on the other hand, looks at the situation from an experimental vantage point, learning by trial and error which of the interventions is helpful and productive, always refining and fine-tuning the hypotheses. Hypotheses are thus always something preliminary, with a short half-life: short-term procedures in a long-term process. They are used for orientation, and they always remain open to correction. Thus, systemic work is always process-oriented, i.e., solutions arise in a collective effort between counselor
Figure 22: Juxtaposition of a procedure based on objective diagnoses and on systemic hypotheses. The arrows show the direction information flow.
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and client of seeking and learning. The client is always the expert on his or her own life; the counselor adjusts the treatment and care to the uniqueness of the client. Milton Erickson repeatedly emphasized that, in principle, one would have to invent a new school of therapy for every individual client (quoted after G. Schmidt, 1993, personal communication). The psychotherapy researcher Klaus Grawe made similar conclusions based on his metastudies on the efficacy of psychotherapy: “Why should the human soul be divided up like the many strains of psychotherapy? For this reason it would be better if a therapist were to look at a patient and say: ‘What is the best possible approach for this person? How can I best bring about changes in this person’s life?’” (Grawe, 2000, p. 305). We can expand these statements to cover social and pedagogical themes as well. If something fails to function, stagnation ensues; we experience the client as rebellious. From a systemic point of view, this is important information and a stimulus we can use in shaping the further relationship and intervention. We assume that we simply have not yet found the proper and adequate intervention, that we have proceeded too quickly or too slowly, that we have not yet determine the right subject matter and need to concern ourselves with gaining better access. Resistance (if there is such a thing) is an interaction variable – not a client variable. Case example: A child therapist remarks in a contribution to a congress that her method of group therapy has a success rate of 70%, with about 20% of the children showing no effect. Her explanation is that these children evidently have pronounced personality disorders and should be seen as resistant to therapy. Following this view, failure originates within the children and is reinforced by objective data and diagnoses. Such a statement, however, blocks out major aspects of the context: The more reasonable statement would be: “20% of the children do not profit from the setting of my nondirective, bi-weekly, 2-hour therapy over a period of 6 months.” When asking “why” something doesn’t work, we must always contemplate the entire context – including ourselves.
In summary, we may draw two conclusions: – Hypotheses should not be judged on whether or not they are true, but whether they are useful in effecting change. Eckhard Sperling, a family therapist and psychoanalyst from Göttingen, Germany, said it very radically: “I do not believe in a theory, I use a theory. And of that theory I use only that part that helps me further . . . and only for as long as it helps me” (after Hosemann et al., 1998, p. 127). – We should always be willing to part with our hypothesis if we notice that no changes are taking place. It is better to switch hypotheses than switch clients! Jochen Schweitzer once suggested adopting a postmodern attitude toward hypotheses: You can fall in love with a hypothesis, even enjoy a candle-light dinner with one, but there’s no need to marry one.
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4.2.1 The Sources and Themes of Hypotheses All information, insights and impressions flow together to generate a hypothesis; how one best gathers and documents that information was shown in the previous Chapters 2 and 3. It is a good idea to practice regarding a situation from all angles – trying on glasses with different-colored lenses, so to speak, and using them to reorganize one’s impressions. Some important questions are as follows: – How does a particular symptom or problem make sense from this perspective? – How does the attempt reflect the solution, the answer to a real challenge? – Where can (must) we presume good intentions with negative results? – Cloé Madanes (1989, personal communication) suggests regarding symptoms as metaphors for important themes in a system. This perspective asks what themes are symbolically expressed through problematic behavior. Here a few examples taken from these perspectives (Figure 23): – The socioeconomic context, the client’s environment: What problems are the clients confronted with that stem from their environment? Might their difficult behaviors be their way of dealing with such surroundings? For example, are a mother’s absurd expenditures her futile attempt at rebelling against the constant lack of funds – the desire to, at least once in a while, have something to “offer” her children? What do the conflicts among the siblings have to do with their living arrangement? – Adaptation demands: When death, sickness, war or relocation strikes – when clients have to deal with major life disruptions – how does their reactive behavior help them to cope? For example, an adolescent’s withdrawal, his distrust of others, may be connected with the constant relocations his parents exposed him to and with his own ensuing lack of long-term relationships. – Temporal processes: How do life events, a difficult past or failed attempts at
Figure 23: Ways of looking at hypotheses
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finding a solution affect each other? What does this say about the present situation? Compare the example of “Sonja” given in Chapter 3.4.2. Life cycle: For example, a child’s entry into school or leaving of the home: Is the system presently stressed by such transitions? How does it react? What steps were successful – and which ones are avoided? For example, because of on-going problems, an adolescent delays moving out and effectively holds the family together. He uses the parents to set limits and care for him, while at the same time demanding more independence. Biographical processes and multigenerational perspectives: What is the story behind the clients’ previous life and learning history? What behavioral patterns have emerged? What baggage full of unsolved problems do they carry around with them? For example, the sadistic father stems from a long family tradition of violence: His behavior expresses multigenerational themes of abuse, irresponsibility and intemperance. Interaction and behavioral patterns: Which behavioral patterns have sprouted up around the symptoms or problems? How are they being nourished by the interactions? For example, two counselors in a group of adolescents contradict each other in their rules and everyday activities. What one of them allows, the other forbids, in part within earshot of the youths. Soon the kids don’t obey any rules at all; the pressure on everyone rises and the two counselors resort even more adamantly to their controversial methods. Structures such as boundaries, subsystems and control: How is the family structured? How are the boundaries, the subsystems, the leadership defined? For example, a small child discovers how to break all rules and still rely on support from the grandmother. Apparently, the boundaries between the generations and authority of the parents must be clarified. Moods, impressions, emotional and somatic reactions: What do I, as a counselor, experience in my dealings with the clients? For example, does the coolness that reigns within the group have anything to do with the child having run away? The sadness a counselor experiences in a family with high aspirations may be a signal of unresolved grief and suppressed needs for relaxation.
4.2.2 How to Construct Hypotheses Forming systemic hypotheses means making assumptions about: – the relationships within the client system, – the interactions between symptoms and relationships, – the connections between the client and the helper system, – the connections between the symptom and the history of the system, – the connections between internalized patterns from earlier systems being reproduced by the clients in the present system.
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Table 6: Construction principles for hypotheses Objectivizing, objectifying
Systemic, fluidifying
Intrapersonal Hypotheses refer to traits that lie within the person
Interpersonal Hypotheses are statements about the relationships and interactions of those involved and their context
Causes Hypotheses provide explanations for the causes (under the assumption of linear cause-and-effect associations)
Functions Hypotheses refer to the meaning and function of the symptoms or behaviors within the respective system
Past Hypotheses illuminate the past
Present and future Hypotheses refer to the present network in systems as well as to the future
Stable over time Hypotheses are on the lookout for stable, unchanging traits and explanations
Variable Hypotheses “dilute” traits into behavioral patterns that vary according to time and space
Negative connotation Hypotheses refer to deficits and the absence of something
Positive connotation Hypotheses presume positive intentions and functions, and always include resources
Removed from context Hypotheses about traits are not bound to the contexts (time, space, others) in which the person acts
Context-oriented Hypotheses connect the actions with the external circumstances and assign a new meaning to them
Conventional Hypotheses are stuck in traditional psychological or sociological thought patterns or conventions
Unconventional Hypotheses differ from traditional thought patterns, and through the use of creative, unusual and bold assumptions they carry an element of surprise, opening up new perspectives
Systemic thought does not assume linear cause-and-effect associations, but rather presumes circular reciprocities – this aspect, too, must be reflected in our hypotheses. Case example: In a school there are problems between teachers and students. The students say they are not motivated because they have such frustrated teachers who fail to get involved. The teachers say they are frustrated because their pupils are so unmotivated. The circular hypothesis would be: Pupils and teachers mutually frustrate and demotivate each other.
In Table 6 we present a comparison of objectifying and systemic strategies in a rather polarizing manner in order to accentuate the differences. Analogously we can differentiate the two basic construction principles for the generation of hypotheses (after P. Gester, personal communication). Case example: Markus, a 17-year-old, comes to counseling with his parents. He regularly wakes up at night, sees the devil in his room (literally, not as part of a dream) and comes running to his parents full of panic. The family has solved the problem by letting the son
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sleep in the parents’ bedroom, the mother having moved to his room. She would like to solve the problem as quickly as possible, whereas the father pleads for patience: The devil apparently avoids the parental bedroom, the son sleeps well there, and it is important that the son get a good night’s sleep to get through his job training. During the initial interview, when working with exploration and creating a sculpture, we learn that the boy’s older brother moved out of the house 3 years ago amid massive conflicts – and that no one knows where he currently lives! While difficult for everyone, the situation seems to be especially hard to bear for the father. Up until now, the family has lived quietly and happily in modest surroundings. All family members report having experienced a nice family life with little contact to others. Of the many possible hypotheses, we choose the following: A new departure is impending, and viewed against the background of a self-sufficient family and the painful detachment of the elder son, this move is dangerous and anxiety-provoking for all. The devil symbolizes this danger. The son is signaling to his father that he won’t be leaving all too soon, which binds the father and son together. We told the family only the first part of the hypothesis – testing the second part by giving the family a task to fulfill: We described the problem as one of detachment and asked the father to go with the son once a week either on a walk or to a bar or pub and tell him about how he himself had left his parents’ home when he was young. This task aimed at getting the theme of detachment out into the open, while also strengthening the father-son relationship. The mother gave her approval for this exclusive contact between the two. At the next meeting, the two men reported that their talks had been very good for them. In two further meetings we followed up on the theme of detachment, also touching on the sadness they felt at the elder son’s leaving. We also emphasized the hypothesis that the son may be worried about the parents: What will they do all alone, with no friends, when he leaves? We spoke with the parents and with the son separately about ways of making contact and how to shape one’s life. After 5 sessions the son, without any therapeutic planning, moved back into his own room. The devil still popped up once in a while, but the son was able to take it. In about 6 weeks’ time he suggested the solution himself: One night the idea came to him to just ignore the devil’s presence and to do push-ups. Then, to his own surprise and delight, the devil was gone! A few training units later and the entire problem had been solved: The devil didn’t want to meet up with such a strong and well-trained boy, so he apparently quit coming and the son slept safe and sound once again. We congratulated him on this very novel solution. In the following weeks we held further sessions with him alone and a final session with the whole family. A further symbolic background to the devil figure emerged: the son’s fear of going out. He lived in a part of town where adolescents were often victims of violent attacks. The close-knit family had, up until then, offered him a way to avoid this problem. In the end, he solved it by joining a martial arts group at a local club, where he found friends who supported him and with whom he could go out in the evening. His parents, too, activated earlier friendships and took some first steps toward accepting his detachment. The symptom did not return (at least not in the first 18 months). Still, contact with the eldest son remained tenuous, and it was unclear whether or not this would ever change.
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4.2.3 Three Practical Tips 1. When forming hypotheses, include the thoughts of others. The constructivistic approach teaches humility and that we do not have command of all truth; rather, only the combination of several perspectives can provide a well-rounded picture. This insight was methodologically adapted in approaches envisioning the reflecting team (Andersen, 1991). During team meetings this means that we must refrain from playing the who’s-right-and-who’s-wrong game and rather listen to each other, with respect for our different approaches. Differing views are placed side-by-side and not inserted into a hierarchy. Sometimes it’s the odd hypothesis that turns out to be the most valuable one. 2. The process of generating hypotheses means oscillating between closeness (trust, recognition, empathy, feeling) and distance (new points of view, change). To this end, the pioneers of systemic thought introduced one-way mirrors or timeouts during sessions. While one-way mirrors or the presence of more than one counselor during a session is normally an unknown luxury, the introduction of timeouts, or short breaks, should be rather easy. They help to air out one’s head, to extract oneself from the pull of the events – which our brains usually reward us for by producing new and hopefully productive insights. Physical activity and a few minutes of doing something completely different can help: leave the room, walk a while, stretch, drink a cup of coffee, look out the window, go to the bathroom. Such interruptions help create distance to old thoughts, which can then perhaps yield a new and better look at things. 3. Beware of “deep hypotheses.” “What I see and what I offer to the clients results from the problem. However, the true problem (emerging from the client’s childhood or character) lies in a deeper region. As an expert and counselor, of course, I can see the problem, though the client cannot (yet). But that’s where we have to go: My role is to lead the client in that direction.” This attitude leads to long and difficult therapy and counseling. It is better to build hypotheses that closely refer to manageable and self-evident matters. Background Text: In Praise of Hypotheses – and the Demonizing of Hypotheses by the Followers of “Not-knowing” The Milan Team (Selvini-Palazzoli et al., 1981, see above) describes how they formulate the initial hypotheses even before the first session has taken place on the basis of information they have received over the telephone. They already try to determine who in the family they will best ask about what matters. The questions they pose and the way they design the initial contact serve the purpose of checking their hypotheses. In this manner, hypotheses become the central element of the session and give it structure. “If however the therapist is passive, only an observer and not an actor, then the family will be the one to guide things, by propagating their own linear hypothesis, which only
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serves to indicate who is ‘crazy’and who is ‘guilty.’ But this doesn’t provide the therapist with any valuable information at all. The therapist’s hypotheses, on the other hand, do provide the family system with strong impulses by introducing the unexpected and the improbable; they limit disinhibition and disorder. . . . Without support for our activities in the form of a hypothesis the sessions would end in chaos and complete anarchy and be discouraging to everyone” (Selvini-Palazzoli et al., 1981, p. 127).
Putting hypotheses together is a lot of work and involves intensive preparation and discussions with colleagues. The hypotheses must yield a strategy for the coming discussions, the development of which also takes time. It is comforting to know that even the maestros from Milano could not do without such intensive prepping. It is not ingenious intuition which results in successful and smooth querying, but thorough preparation of the session. The advantage of the hypothesis-oriented dialog lies not only in the way it structures and organizes the sessions; rather, the longer one asks questions with the sole purpose of creating a hypothesis, the more the system concerns itself with the content of the hypothesis without its having to be formulated precisely by the counselor. Once a hypothesis-oriented counselor has finished a session, anyone present will develop new ideas and perspectives about what is true about the hypothesis: The hypothesis quite naturally becomes the centerpoint of the exchange with the client system. Yet other authors soon judge this circumstance in a very different way and formulated an opposing view. According to them, the counselor should not formulate hypotheses at all, but rather only lead the discussion from the position of “not-knowing.” Anderson and Goolishan (1992, p. 29) describe this position as follows: “The position of not-knowing is accompanied by the overall position or standpoint whereby the therapist’s posture radiates a rich and sincere curiosity. That is, the actions and the attitudes of the therapist express the need to know more about what was said than the opinions and expectations of the therapist concerning the client, the problem or what needs to be changed. The therapist assumes a position that allows him or her to be ‘informed’ by the client . . .” “Most of us find it extremely difficult to disregard our own frame of reference and to listen to the client’s story from the perspective of that client. We are used to filtering everything others tell us through our own experiences and beliefs. We believe that training in the helping professions even tends to exacerbate this problem by concentrating our focus on gaining information while listening to clients in order to better assess the situation” (De Jong & Kim Berg, 2012, p. 47 f.).
But it is exactly these sorts of problems and difficulties of the helping professions that distinguish the hypothetizing approach of the Milan school. In the narrative approach described above, hypothetizing does not play a central role in the dialog with the system; in the narrative approach, the counselor is interested exclusively in the tale the client tells, the client’s view of the
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world and of course the client’s solutions. The work object is the client’s narrative. Change can happen by changing the narrative, by changing the client’s view of things. This approach always stays at the level of the narration – one of the basic epistemological differences from the Milan model. The latter uses the client’s narratives to recognize the structures that lie behind the story and to develop hypotheses about these systemic structures. For the Milan Team, narration is a way to get inside the structure, whereas the narrative approach does not even assume the presence of such a structure. “We do not deal with what is hidden, ‘since everything is wide-open’ . . . We do not need a penetrating, but a clear look at things. It is true that, in a certain sense, there is something ‘hidden’ – but not because it lies under the surface, rather because it lies at the surface, directly in front of everyone’s eyes” (Wittgenstein, 1971, quoted in de Shazer, 1994).
The solution-oriented narrative approach completely concentrates on the ideas for solving the problem present in the client’s story; this imparts the counseling interview with both structure and order. In the Background Text of Chapter 3 on the controversy between normative and neutral approaches to working with a system, we noted the agreement between the Milan approach and Minuchin’s solution-oriented approach toward the normative theory, quoting Palazzoli and de Shazer. The epistemological agreement between the position of Milan and that of Minuchin may be seen in two important points: (1) A structure lies behind the observations and descriptions. (2) Recognizing and depicting the structure of the system in the form of hypotheses is a meaningful and necessary act in the process of getting rid of the symptoms. The Milan school tries to recognize the family’s game in order to break up the homeostasis and thus induce new developments; Minuchin seeks to find the structures present in the system and to change those structures. Both approaches are structuralistic. De Shazer, on the other hand, may rather be seen as poststructuralist – he doesn’t even look for structures behind the client’s story. Epistemologically speaking, it would seem to us that perception and cognition are not possible from a position of “not-knowing” – if seen radically and in its final consequence. According to Schulz von Thun (1998, p. 61 ff.), from a communication-theoretical standpoint the recipient of a message is responsible for its content. Recipients must decode the message and give it meaning, for which purpose they use their experiences, their opinions and their mental models: These determine what recipients understand. The recipients of a message cannot absorb a message that goes beyond their own cognitive and interpretative abilities. Maturana and Varela (1992) arrive at similar conclusions. They describe the connection between two systems as a structural interconnection. Within such a conglomeration, matter or information can pass back and forth be-
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tween the systems, whereby the structure of the receiving system determines the meaning of what is transferred. If a cell absorbs matter, then the construction and structure of that cell determines whether the matter is, finally, nutritional, incompatible or perhaps even toxic. Information absorption from the position of “not-knowing” is, in the end, impossible. It can only serve as an attempt to understand the other person in his or her own world (inasmuch as at all possible), putting aside as much as possible one’s own views and experiences, one’s own knowledge about systems, communication and relationship structures. We see the advantages of not-knowing in the following points: – One encounters the clients with respect; one is open and curious about their specific way of living and about their own authentic solutions. This means, too, that we create room for solutions that are not present in our own mental models. – Playing the role of an inquisitive, well-meaning researcher who joyfully ponders and reacts to the ideas of the clients can be very pleasing indeed. It creates a foundation of trust that can become the basis for successful change (see the comments on the generic principles and overall functional factors of psychotherapy at the beginning of Chapter 5). – This position raises the self-esteem of the clients and inspires their creativity, both of which are helpful in overcoming difficult junctures in life. As executed by de Shazer, a hypothesis underlies the position of “not-knowing,” albeit a hypothesis that is the same for all client systems and all types of problems: – One concentrates on the solutions suggested by the client system. One consistently pushes the client system toward the development of and everincreasing realization of solutions. The result is true development and change. This basic assumption has nothing to do with the radical position of “notknowing” and the conscious foregoing of clinical concepts. It consists indeed of a clinical concept and a hypothesis, which in turn very clearly structure and order the dialog with the client system. In our opinion, the inherent dangers of the “not-knowing” position arise when we assume that we are very well able to carry on conversations in an unbiased, unconditional and value-free manner. – Under these conditions, we repudiate our interpretive powers and act as if we do not compare what we hear with our own mental models – our own cognitive schemata. In a sense, we are actually increasing the danger of suggesting to the client the value of these schemata via completely unconscious, paraverbal means, without having to explain the circumstances to ourselves, let alone to the clients. In video sequences we can observe how therapists control the attention of clients through very subtle nonver-
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bal means – even if they consider themselves to be nondirective and neutral. – Our professional knowledge is valuable empirical knowledge. It would be irresponsible and very inefficient if we were to restrain ourselves from imparting this knowledge on later clients. Yet we must introduce it with humility and respect for the self-regulating nature of a system and not force it upon the clients. Our own position toward this disaccord within the systemic camp supports one side as well as the other. The idea of not-knowing can be very helpful when exploring extensively the way the system sees things, recounts things and interprets things. From what we hear, we develop hypotheses – if necessary, even structuralistic hypotheses. We consider this important for explicating our inner conclusions and making them available to revision: by ourselves, by the clients, by other colleagues or by the results of actions based on these conclusions. We are well aware that hypotheses tend to constrain the possible options; but they do that no matter whether we are conscious of and express them or not – or whether we act as though they didn’t even exist.
4.3 PreparingHypotheseswhenWorkingwithForeigners
4.3 Preparing Hypotheses when Working with Foreigners In the complex helper systems of other cultures we often discover very contradictory standpoints about what is causing the problems and how best to solve them. Intercultural teams are well acquainted with situations in which heated debates take place about whether the foreign family should be supported or rather confronted – about how much assimilation can be expected of them. Much partisanship and identification is found here, with creeds taking the place of sober professional judgment. The many and contradictory hypotheses proffered for the counseling of migrant families represent not only an opportunity but also a source of many questions and problems: – Which of the many hypotheses shall be our working hypothesis? – Why do we decide for or against a hypothesis? – Which of our implicit assumptions about migration and mental health are decisive here? In such cases it is best to have a model available for organizing and classifying our hypotheses, to ensure that the discussion returns to methodological terrain. We like the model developed by Norbert Kunze, head of an intercultural team in Reutlingen, Germany (Kunze, 1998). According to this model, hypotheses may be classified in three categories:
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a) Psychological hypotheses: Problems are explained exclusively via psychological theories. Depending on the respective school the counselor belongs to, there is an emphasis on psychoanalytic, behavioral, humanistic or systemic explanations. The fact that one is dealing with an immigrant family is of little relevance here. b) Culture-specific hypotheses: The context of a “strange” or “different” culture is viewed as relevant to the problem, or rather: the relationship of the helpseeking immigrant family to its own background explains the problem. Thus, the source of the problem lies in the client’s culture, even though the behavior may not be a problem within the client’s cultural context and only becomes one because the family is no longer in its native cultural environment. The difference between, or incompatibility of, the two cultures is seen as the true reason for the problem. c) Migration-specific hypotheses: Here the immigration situation, the status of being a minority, the history of migration in general, racism, xenophobia, discriminatory institutions as well as the reactions of the immigrants to life in another society, their experiences as minority figures and the consequences thereof – all of these are seen as the reasons behind the problems. To illustrate this model, let us look at some hypotheses drawn from a supervision session that took place as part of a conference (Conference on Migration of the National Catholic Counseling Association – BAG) in 1998 in Freiburg, Germany. Case example: The supervision group consisted of counselors from various cultures as well as the ethnologist Tirmiziou Diallo from Frankfurt and Norbert Kunze. A (female) colleague introduced her work with a binational couple that had several children and now lived in Germany; the father was from the Ivory Coast, the mother was German. The counselor mentioned that the father consistently spoke of “my children” when speaking of the couple’s children. During the supervision the following hypotheses were offered (Figure 24): – Psychological hypothesis: The husband wants to say to the counselor and to his wife that he sees the children more as his and belonging to his sphere of responsibility – and that in the end his custodial powers are greater than those of his wife. This is an implicit threat that he will assert his rights in the case of separation. – Culture-specific hypothesis: The use of the possessive pronoun “my” or “our” is much more differentiated in West African tribes than in European or Anglo-American society. In West Africa, there are two different expressions for “our”: One is inclusive and expresses that the object in question belongs to both the speaker and his group and thus also to the listener; another is exclusive and is used when the speaker wants to express that the object belongs to his own group but not to that of the listener. As a member of such a cultural and semantic background, he may be uncomfortable having to express himself in this matter in a less-differentiated (European) way than he is used to. If he uses “our” in the first sense, he might have the feeling of attributing his and his wife’s children to the counselor and making her part of the family (or at least being ambiguous about it). His solution is to use the phrase “my children” to express the fact that they are not the counselor’s children, and that she carries no responsibility for them, only he and his wife do.
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Figure 24: The three categories for the classification of hypotheses and assumptions when working with migrants (after Kunze, 1998) – Migration-specific hypothesis: As a Black man in a white European society he has surely
experienced some discrimination. Indeed, he considers himself part of a discriminated minority. Yet he would like to show the counselor and his wife as well that they are his children, that they belong to him, have his skin color, that he sees them as part of his people, that he would someday like them to come to Africa – and that he would defend them as members of a minority against the German majority society.
With this model we can assign the hypotheses to the three categories. The following requirements seem to be reasonable: – One should establish hypotheses for each of the three categories. – These hypotheses should be tested together with the clients. – The relationship of the counselor to the working hypotheses should remain easygoing (see Background Text on hypothetizing above). But why should counselors be so careful and so self-critical of their own assumptions and working hypotheses when dealing with migrants? When working with migrants, the danger lies in identifying with one’s own nationality, even idealizing it, or ideologizing the known and the unknown. This is true for both native and foreign-born counselors. A further argument for employing the three types of
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hypotheses is that families themselves often have a “trifold” way of thinking about themselves and their problems. They, too, frame their problems in a culture-specific, in a migration-specific, and in a psychological manner. Often there are even different fractions within a family regarding this question. Using the three working hypotheses allows us to switch between the hypotheses from time to time and to make each of the three hypotheses the object of study. One will quickly notice which of the three is met with the strongest response within the family and can develop it further. For the family it is advantageous to be mindful of all three aspects of their situation. The reaction to such a broadly based approach is often positive. Reducing the three categories to a single one, on the other hand, has a number of inherent dangers: – Using only the psychological perspective leads a psychologization and neglects all cultural, sociological, political and social aspects. – Using only a culturally oriented approach means ethnizing the client while neglecting the client’s individual psychological biography, indeed that of the entire family. Further, sociological, political and social connections tend to slip out of sight. – Reducing one’s view solely to a migration-specific one results in the politicization of the client. One neglects the individual psychological development and the development of the entire family as well as the client’s specific cultural background and the differences found among cultures. 4.4 DefiningGoodGoals
4.4 Defining Good Goals “Having lost sight of our goals, we redouble our efforts” (Mark Twain). This saying describes what happens in everyday life all the time – whether in politics, in corporate life, in social and educational situations, or in our own daily routines. Setting goals can help us to organize our activities and separate the necessary from the irrelevant. However, Twain’s statement stands in contrast with construtivistic concepts: Heinz von Foerster (1988, quoted by von Schlippe & Schweitzer, 2007, p. 210) warned against a purely goal-oriented therapy, which in his opinion would hamper the developmental possibilities of the family. Von Schlippe and Schweitzer (2007, p. 210) thus recommend setting only short-term goals, “such as asking the question ‘What has to happen today that you can say at the end of the session: That was a good session.’” Of course, it is equally important to “inquire about the visions of possible solutions in systems needing counseling,” although such ideas should be viewed only as temporarily valid statements about present developmental perspectives.
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Background Text: Goal-Oriented Approaches – or: Does Perturbation Stimulate Open Processes? This question touches on both aspects of epistemology and humanity. Maturana’s concept of “perturbation” is usually interpreted as meaning “to destroy.” Ludewig (1999, pp. 78 ff.) describes the therapeutic intervention as a “significant destruction of family coherence within a therapeutic system.” The term refers to the fact that both families and systems are not controllable, and that interventions that intend to induce change should concentrate on destroying old and crusty thought and behavioral patterns – trusting that the system will react to this destruction by forming other, perhaps even more functional forms of organization. This idea also includes the belief that complex social systems are effectively unsteerable: No one can say in advance which effect an intervention will ultimately have. But any intervention, this we do know, will upset the existing equilibrium of the system (homeostasis) so much that the system has to change in order to return to (perhaps another) equilibrium. In this sense, of course, long discussions about goals are counterproductive as they hinder the open-ended developmental process. Discussing goals may be used, however, to import new ideas into the system. In our own experience, these concepts may be hard to swallow in structurally weak systems from marginal social groups, in community projects, in groups of violence-prone adolescents, with mistreated or abused persons. Instead, we start with three premises: – In many contexts we are forced to set goals because of institutional mandates or our own value orientation. – The ability to embark in truly new directions by first tearing down the old is not equally pronounced in all clients. Some systems that have a considerable supply thereof can proceed in this way. Others that have already been confronted with much destruction, aberrations and confusion in the past may benefit more if we supply support, orientation and concrete directions. If change means introducing something new into a system, then sometimes a firm structure is what is new to families with structural weaknesses. – Even if we try to remain value-neutral and expectation-neutral, implicitly we often turn to our own value system, which does have certain goals. Our debate about hypnotherapeutic techniques clearly showed that we always influence others in our communication with them. Especially when we are attempting to approach things nondirectively, without firm goals, do these influences become all the more subterranean, expressed only through subtle, nonverbal interventions. This phenomenon is another reason to always shift to working with goals on a completely conscious and transparent level. Analogous to Watzlawick’s communication axiom one could say: “One cannot not manipulate as long as one is communicating.”
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Of course, on the other hand, we do recognize that systems don’t like to be dictated to; they don’t like to be told to go some straight path, but rather tend to decide on their own what to do with the interventions offered by the helper. Perhaps the two poles – “Goals are useful” and “Systems cannot be instructed” – can be dialectically conjoined: – Depending on the system, we vary the degree to which we work with goals that provide orientation. We assume that they will be continually reviewed, and we are open to all corrections, changes or substitutions – similar to our description on generating hypotheses. – We proceed in a narrow or wide corridor of goals: The paths to a particular goal can be very different, and we do not presume to know in advance what will turn out to be best path for the respective clients, but rather strive to find that out by working with them. Working with goals has a number of other useful effects:
– Goals focus behavior on a reference point. – Dealing with goals distracts the clients from their problems. Thinking
– –
–
–
about the future activates their resources. “Thinking,” Sigmund Freud said, “is test-run action.” Good goals support and appeal to one’s motivation to put an effort into changing things in the foreseen direction. Goals serve as a sort of lighthouse when the going gets rough; they light the way and encourage one to perseverance: “It’s worth it and you can make it!” Pursuing goals helps to determine exactly what clients want, what’s important to them, what they wish for and what in turn is not so important. Carefully sifting through priorities also helps to avoid excessive demand on their own resources. Goals are good for the self-esteem of both the clients and practitioners: Their own behavior is put to the test. Although this may sometimes also cause anxiety, everyone rejoices at success and can celebrate it.
The latter point is something we noticed particularly with our American colleagues. They possess a very distinctive and high level of professional confidence, which by far tops that of their European colleagues. The latter tend to philosophize more about how human development is an open process and very, very difficult, and how impossible it is to describe results – let alone to promise or contract for success. American counselors, however, lecture openly about the newest “Don’t-Worry-Be-Happy Program” with 17 steps or the “Five Guiding Principles” or the “Six Outcomes” of this method or that method. To us Europeans this sometimes seems a bit superficial – but, if we are honest, it also leaves us more than a little envious of their clear and self-assured attitude. The two standpoints seem to have converged somewhat by
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now, which is surely owed in part to being courageous enough to talk about goals. The contradiction discussed here between the two meaningful perspectives “Intervention as open-ended disturbance” and “Intervention to reach goals” cannot be completely resolved. Both are reasonable approaches, and we can only decide which to apply depending on the situation: Which offers the greatest advantage in the respective situation? Yet both positions are and remain constructions, not truths. Theories should be followed only for as long as they provide good results. It is helpful to keep the principle mentioned above in mind: Every question is already an intervention. Working with goals, therefore, is not merely the preparation of interventions, but rather a source of new impulses for change. Attractive images appear before the inner eye, internal search processes are activated, issues are resolved and sorted out, the relationship between practitioner and client is consolidated, questions signal interest and commitment. This alone suffices to kick things off and make further work easier.
4.4.1 Criteria for Formulating Goals Many existing measures, however, aren’t all too useful for determining clear goals. Vague declarations of intent are unsuitable and cannot truly provide a plan of action (see Berg & Kelly, 2000, pp. 270 ff.). There is always room for “improving parenting skills” – no matter how hard one tries. Just as “better communication in the team” remains a noble and desirable goal even after years of supervision. The prerequisite for knowing when one has actually arrived at one’s goal is to formulate a precise description of what things will look like once one has indeed arrived. Only then do helpers and clients have sufficient clues to recognize their success – and appreciate it. Seiwert (2000), in his many publications on the topic of time- and self-management, pointed again and again to the importance of clear goals. He speaks of “smart goals” and summarizes in the acronym SMART his five criteria for good goals: – Specific, – Measurable, – Action-oriented, – Realistic, – Time-limited. Walter and Peller (1992) add to this definition of goals two further aspects: use processual language (i.e., more verbs and less nouns) and use the language of the clients.
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Specific goals It is helpful to describe the situation as though one had, in fact, already reached the goal (no conjunctive moods here: should, could, would). Unspecific goals in some distant future feel tentative and nonbinding and lack the pull to get people excited. They also fail to show concretely how the goals can be reached. Case example: “I will revise my daily schedule so that I have the time to eat in peace and quiet. I will make a meal plan every Sunday along with a matching grocery list. I will be mindful of eating more fruit and vegetables. At least one meal a day should be a salad or vegetable dish. Every day I will do 30 minutes of physical exercise.” Not: “I want to lose 20 pounds.”
Helpful questions on the path to the goal: – “What, exactly, will that look like, once you’ve reached your goal? What will you be doing differently? I would like to understand what you mean. Can you put it into concrete terms?” – “What can we do now to start you on the path to that goal?” – “How, precisely, will you proceed with this?” – “What could we do if . . .?” Measurable goals The more concrete the goals are defined, the better one can verify whether they have, in fact, been fulfilled. Case example: “I would like us to listen to each other more calmly, withholding our comments for a while. I would like to learn to put my criticism into words earlier – instead of waiting and letting it eat away at me. I could check that by thinking about my day when I’m lying in bed in the evening, checking whether I have really told my husband everything I wanted to say or chosen a time to do that. I also want to talk more about things that I like.” . . . “How often?” . . . (pauses to think) “Well, you surely have the opportunity to compliment someone at least once a day, I would think.” Not: “My husband and I need to better understand each other.”
Questions about the level of standard are important. Many clients have unreasonably high expectations when they go to counseling – they think all their problems will just disappear entirely. Scaled questions help to establish realistic expectations and are a good way to come to better definitions of behaviors otherwise difficult to define. Case example: A young man says that his goal is to find a partner (very good: a concrete, verifiable goal!). During counseling he tries to define his horizon for that goal. In the following we present a few of the questions and snippets of conversation during that session. Counselor: “That then would be the 100% solution. How quickly do you think you could reach that goal?” – “How much of that would we have to attain here in counseling for you to say, ‘OK, that’s good enough, I can do the rest by myself’?” – “So, 75% you say. And what, exactly, would you have reached at the 75% mark? What would be different from the way it is today?” (Later on, after the client described the 75% mark as being able to approach girls in a more relaxed way.) “What does that mean to you, ‘relaxed’? Where in your body do you most notice what it means to be relaxed?” – “Any other places?” – “If I have understood you correctly, that
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means that instead of having a knot in your stomach and frantically searching for some topic to talk about you would develop a sort of easiness about you and could talk about things that interest you. How would you recognize that this is the case? In which situations have you experienced this feeling?” The conversation is thus oriented toward a precise but realistic goal of (more or less) easygoing conversations with young women.
Action-oriented, positive goals Formulating goals is meant to be a motivation for action. One describes exactly what one wants to instead of merely demanding that the problematic behavior end. This results in an internal image of the desired final state, which, in turn, can help to jump-start the intended change. Case example: “When someone gets on my nerves, I try to control my anger. I go away or take a timeout. I try to work it off by doing something strenuous, like hitting a punching bag. When I’m more or less back to normal I can say what was bothering me.” Not: “I shouldn’t hit back any more.”
Goals that have been expressed should govern the client’s activities. The goal of an intervention is to expand the client’s self-responsible behavior. Thus, goals must be attainable only with the means available to the client. And they have to be formulated such that they expand the areas of responsibility and experiences of competence. Case example: “I will take a more active role in school, even though the teacher prefers others.” Not: “Only if the teacher involves me more will I take part in the lessons.”
Helpful questions on the way to the goal: – “What will you do instead?” – “What can you do differently?” – “How can others – and how can I, myself – recognize that my goal has been reached?” – “How would you act (feel, think) if . . . (you were more self-assured, could control your anger, were more attentive to your child, your depressive thoughts disappeared tomorrow, etc.)?” Realistic goals The idea of “optimal frustration” stems from the developmental theory of psychoanalysis. This term means that goals create movement (change) if they are, for one, far enough away to create a certain level of frustration, and a certain effort is necessary to overcome that frustration. Additionally, there needs to be a realistic chance of actually reaching the goal on one’s own if one tries hard enough. Case example: “No one does that for me.” – “Mama won’t get the toy for me, so I’ll have to crawl over there myself.”
Time-limited goals Determining a point in time by when the goal should be reached creates a certain pressure to act. Dealing with the question of how much time will be necessary to
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reach the goal serves the additional purpose of reducing excessive expectations of success to a more realistic level. Processual language Behavior is best described not in terms of nouns (e.g., smoking) but more as a process – as a series of feelings, thoughts and actions (“I smoke when I am stressed and think I can’t afford any other type of relaxation”). “How”-questions facilitate the development of an entire behavioral sequence, from the moment of triggering to the reactions and consequences in one’s environment. Case example: “I will first listen to what my child has to say before telling him what I think he should do.”
Helpful questions on the way to the goal: – “How will you do that?” – “How will you proceed?” Using the language of the client The goal must be meaningful to the client and emotionally close to home; likewise, the way it is worded and its value content must fit the client’s frame of reference and life experiences. When formulating the goal, it has proved more effective to use the client’s choice of vocabulary instead of some abstract lingo. Case example: “So, instead of smashing his face in when he looks at you stupidly, you think to yourself: ‘Hey, asshole, you can kiss my ass if you think I’ll get into trouble with the cops again because of you’ – and then you turn away and say to your bro’ ‘Come on, let’s get out of here!’ Will that work? How can we help you do just that?”
In this example, the male competition that leads the client to lash out has been redirected to a challenge: If I let myself be provoked, am I the dumb one? Can I stay cool and let the other “bounce” off me? The formulation takes up an important motif of the young man and attempts to use it to reach the desired goal.
4.4.2 Goals for Placing Children in Foster Homes Placing children in foster homes involves a number of very specific challenges to everyone: Children are separated from their parents, which can be experienced by some as a relief, by most, however, as traumatic. The parents are confronted with their own failure – they are incapable of offering their children a proper upbringing, which is now a public matter. This results in many impossible, hidden and ambivalent mandates: “Can you please set our child straight?” combined with “Please fail – then we won’t feel so bad about having failed ourselves since not even the pros can get our kid back on the right track.” Michael Durrant (1993) wrote a book on this subject with the fitting title You Can Count on the Strengths. In it, he suggests defining inpatient treatments or placements as transition rituals and staging them as such. Transition rituals are all about providing the space for new behavior that can be practiced and tested with the
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support of others. Durrant (p. 61) makes some suggestions about how to frame foster placements differently, and how to circumscribe the themes and goals: – The theme must be clear to the family and make sense. – The theme makes a different description of the situation possible, bestows a new meaning on things, thus countering the feeling of hopelessness and defeat. – The theme signals to the family that their fate lies in their own hands, and that they can be transformed from victims to problem-solvers. – The theme is goal-oriented and not problem-oriented. – The theme offers parents and their relatives a way to partake in the process of change. Case example: 12-year-old Sven is described by his single mother as violence-prone: He hits her, his siblings and his schoolmates at the slightest provocation. From the child’s anamnesis we know that his father, who lived with the family until the boy was about 6, as well as the mother’s later partners were all prone to violent acts. After being admitted to an inpatient ward, Sven talks about how his anger overcomes him – and that he doesn’t like himself in such moments. For him it is an exception to have “good days.” Sven listens carefully, is attentive and agrees to our framing of his aggressiveness: “You’re right to have so much anger in you: Your father and all other men in the family hit you and eventually left the family. That would make anyone angry. But you don’t have the control over your anger; rather, it would appear that the anger has taken control over you.” The theme and goal we define as follows: While on the ward, Sven should practice keeping his anger under his control. He should try to have as many good days as possible. The mother is exonerated and can learn to once again see Sven’s good sides, which of course is impossible when he’s hitting her. Everyone can practice living together without violence when Sven returns home. Case example: A young woman began hearing voices and doing strange things, which led to her being ostracized in her own family and in the neighborhood. She was committed to an inpatient psychiatric ward to keep her out of trouble and to give her the chance to “recuperate.” This description reflects her own statement of being completely stressed out and exhausted by all of this. In the course of treatment, she will be taught to learn to live with her voices such that she can have a normal life, go to work and meet with friends. Together with the therapist she can learn which medicines could help her do this. And she is to learn to recognize early on the mounting stress, which is causing her to hear voices – and to neutralize that stress before it affects her.
4.4.3 Describing and Using Goals: Two Instruments We would like to introduce two instruments we use to describe goals concretely and to make them binding. The two checklists have overlapping functions and should be adapted to the case at hand. Behavioral therapists have developed a number of sophisticated goal-intervention systems (Table 7). We’ve adapted one example for our purposes (Table 8); it is suitable for one’s own planning and reflection on the most important aspects, but in many circumstances can be worked out together with the clients (Table 7, see Boelicke, 2004).
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Table 7: Developing goals for an intervention (after Boelicke, 2004). My goal: Competences, resources
Problems
What do I have/can I do already?
What do I still have to learn?
Who supports me and who can help me?
What hinders me?
Exceptions: Which situations have already gone well?
What do I need?
Table 8: Case example of a young mother (adapted from Boelicke, 2004) My goal: Training in food service industry Competences, resources
Problems
What do I have/can I do already? Graduated from middle school. I can cook well, I am friendly.
What do I still have to learn? Persistence, hanging on when the road gets rough
Who supports me and who can help me? My two girlfriends encourage me. My mother takes my daughter now and then.
What hinders me? Fear of losing my daughter. My boyfriend is so jealous. I give in too easily.
Exceptions: Which situations have already gone well? Completing my degree was not easy, but I did it. Because I wanted to succeed, and because my friends pushed me on.
What do I need? Daycare for my girls. Information on getting training. Maintaining boundaries between myself and my boyfriend.
Methods, first steps: What can I do, how do I proceed? Get information from the job agency and from employers with training positions. Going to Youth Services. Starting an internship to try out what it’s like to go away and leave my daughter for a few hours. Taking a course on “Self-assertion for women.”
By when? Within 2 weeks
In 6 weeks’ time Sign up next week
The first row of the table focuses on a classical analysis of resources and problems; the second on the forcefields as well as the positive and negative factors in the client’s environment; the third on successful coping experiences and the prerequisites for reaching the goal. All of which offers a realistic basis for contemplating concrete steps. Berger and Spanjaard (1996, p. 41 ff.), in their handbook on their “families first” approach1, introduced an instrument that, in a somewhat altered form, can be useful in addressing concrete goals and the means to realize them. 1 This approach is meant to be an intensive, structured, time-limited way to work with crisis-shaken families, so that they can learn from ordinary situations how to manage crises as well as to build up and expand important competences for use in everyday life. The approach harks back to the Homebuilder Model (Kinney et al., 1991), a form of domestic crisis help developed in Seattle which was adapted by a Dutch group for European standards of youth counseling.
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Case example: Table 9 shows a case example from the family counseling of a single mother with an aggressive son. The goals formulated there were set up together with the mother during many weeks of contract negotiations. The first steps meant providing her with support regarding the organization of her household and taking care of her son. The initial small successes gave the mother the confidence to take on more difficult matters and to do more.
The example given in Table 9 shows how to put the principle of self-reliance into action: The goals set a behavioral framework for the mother – although she sees the son’s behavior as the main problem.We had to do some persuading to get her involved in becoming a part of the solution and to formulate specific goals. The most important factors were the quick, hands-on results achieved at the beginning of counseling. Table 9: The development of goals in family counseling with single mothers. Situation
Goals
Sometimes Sven fails to do what is asked of him: to come to the dinner table, to go to bed, to help clean up, to pack his things for school.
Give Sven clear orders (so that he can learn to listen); keep at it even if he doesn’t listen the first time.
Sven becomes aggressive when he is angry with me. He berates me and calls me a “dumb cow, whore, bitch.”
I set strict boundaries for Sven and can calm him down. He has to learn to say things in a calm voice even when he’s angry.
Order/priority
Sven is bored if he can’t go outside. I take the time to figure out what At home he can’t occupy himself ex- Sven could do when he’s at home. cept by watching TV. The daily routine is chaotic. In particular, there are no regular meals.
I learn to see to it that there are regular meals at home. I learn to plan the meals in advance, buy the necessary groceries and cook them on time. I set up a schedule with Sven when he can help me.
I can’t keep track of my finances.
I make a list for noting expenditures and income. I put all the bank receipts in one file.
4.4.4 Planning and Evaluating Interventions In organizational psychology there is a well-known two-part strategy which is used when crises arise in the business world: Quick, decisive steps produce shortterm results (quick wins), and the long-term planning of remediation strategies is attacked simultaneously to ensure that radical reorganization takes place and the company remains stable over time and can continue to prosper. The quick initial measures have the following functions:
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– To plug the largest holes and to quickly attack the greatest problems in order to mitigate the situation and create the conditions in which working on long-term goals is still possible. – To use the quick results to build up confidence, courage and self-assurance for the coming changes.
These principles can be equally helpful for counseling and therapy. Especially in systems with a number of difficult problems (“multiproblem families”) does the dilemma arise which of the many problems to attack first. Classically, when solving problems, one considers three criteria: 1. Significance: Which matter is the most important for the system? 2. Urgency: Which fire needs to be put out first? 3. Feasibility: Which problems can best be solved? From a systemic point of view there are no clear guidelines since every system has its own unique organization; where to begin can be determined only through an experimental process, though sometimes past experiences can supply hints about which of the three points one best focuses on. Building up relationships and trust One major factor in the success of any intervention is the establishment of a trustful relationship (see Grawe 2000, 2005; see in more detail in Chapter 5 below). In the initial phases one should thus first tackle those themes and problems that allow a good relationship to be established – above all where the clients gain trust and confidence in the counselor’s abilities. To the client, the counselor should be someone who is supportive, validating and respectful. Case example: In an assisted-living facility for the mentally ill the counselor learned of the resistance a female client was exhibiting toward all therapeutic offers. It turned out that she had experienced a great number of psychotherapeutic interventions over her long psychiatric career – mostly with little success. She knew all the jargon and was extremely skeptical, even defiant. The counselor respected this stance and showed great respect for it; he agreed with the client that he would offer her help only in surmounting her daily problems, such as moving, furnishing her apartment, shopping, daily planning, etc. He went along with this, but always took care that it did not turn into a sort of partnership. After 6 months the level of trust had risen such that the client began to confide in him about her life and career problems. Apparently, the most important thing to her was that she retained the initiative and the control.
Quick successes This is an adjunct to the one above: Nothing furthers trust more quickly and reliably than a successful cooperation. Here, too, the research done by Grawe (1999) on the functional factors in psychotherapy clearly shows that trust in the competence of the therapist plays a major role. Quick successes translate into experiences of competence on the part of the client, which in turn means confidence in the ability to tackle difficult tasks. Whether in business negotiations or
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in politics, the basic principle has proved true: first take care of things that can be quickly realized or agreed upon. This helps to build up steam for tackling the more difficult problems. Vehicle development This is a concept I (R. S.) owe to the family therapy teacher Carol Grammer (personal communication, 1982). Despite its somewhat cumbersome title, it has proved effective again and again. According to this principle, topics are suggested during the early phases of an intervention which can later used as vehicles for the introduction of broader themes. Case example: In a family with very divergent approaches to child-rearing and some rather extreme disciplinary problems I might suggest as a start-off that the most urgent thing is to solve an everyday problem, for example, how long the child is allowed to watch TV in the evening and when and how the child should go to bed. I dramatize the problem somewhat and explain that the child has become so strong that the problem can only be solved if the parents work on it together. I use the (really quite small) problem as a vehicle to teach the parents very pragmatically how to cooperate. The background problem – the parental conflict – is not even explicitly mentioned. Rather, I try to invite the parents to take on a task-oriented position which simultaneously allows them to work on their relationship. Often, after two or three such successful vehicle themes, their overall relationship improves considerably. Case example: In the example quoted above concerning Markus, who saw the devil in his room, the hypothesis was that the background problem behind the young man’s failure to leave home was the poor relationship between Markus and his father – and the fear both parties had that the relationship could break apart completely (as it had with the older son). Accordingly, I made the suggestion that they spend one evening a week together talking about the family and how the father himself had left home. The focus on the theme of detachment became a vehicle for establishing a good relationship between father and son. And it did, in fact, have the paradoxical effect of allowing the son to orient himself more to the outside world over the next few weeks.
Evaluation The clearer goals are formulated and agreed upon, the better we can register progress. This is not some formalistic pretense; it has immense effects on the self-esteem and especially the damaged self-image of our clients. It helps us to find out how our behavior is coming across, which we desperately need in order to formulate further hypotheses and plan interventions. For this reason, systemic counselors should always take the time for evaluation. – This can take place informally at the beginning of each session via change-oriented questions: “Have you succeeded in anything since our last meeting, and if so, in which regard – even if only very small changes?” – Scaling questions are also well-suited: “If at the beginning you said that you have a 20% grip on your eating habits during conflicts, and that it would be a good goal to have an 80% grip on them, how would you judge the present situation? What do you do now, what have you discovered helps you raise your level by 30%?” – Finally, one can also use form sheets (see Table 10).
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Table 10: Evaluating goals (0: no progress, +1, +2, +3: little, good, very good progress, –1: regression) Goal
–1
0
x
Get information from job agency and from employers with training positions Go to Youth Services
+1 +2 +3 Achieved how? Why not? Consequences
x
Once I had started it was a lot of fun and interesting. I noticed that people like it when you approach them on your own and ask. I’m proud of myself that I could do that.
Didn’t have the time – and didn’t have the courage. I was afraid they would ask whether I would be neglecting my daughter by getting some training. The guardian doesn’t have to come along, but it would be helpful to talk with them on the phone beforehand so that I know where to go and whom to talk to.
This grid was developed for project management in companies to allow ongoing planning and other arrangements to be gauged for their effectiveness. But it can also be used to good end in systemic work if we remember that we are always dealing with living systems that may take surprising turns. Otherwise, using such instruments can be frustrating. 4.5 TheGroupasaSystem:ConstructingHypotheses
4.5 The Group as a System: Constructing Hypotheses In Chapter 2.5.3 we provided some suggestions on how to observe interactions in groups. In Chapter 3.5 we suggested a method for describing the social dynamics of groups and for subsequently preparing hypotheses about those dynamics. In this chapter we turn to the topic of constructing working hypotheses and planning interventions in groups. First we describe the contexts we postulate.
4.5.1 Different Group Contexts, Different Demands on Counselors We differentiate here between two contexts and contracts of group work, each of which demands a different procedure. In the first case, the head of the group has the task of working on the relationships, the sensitivities and the overall psychological situation of the individual group members – for example, in therapy groups, in work teams that have come together to work on their team structure and cooperation, or in groups situated in inpatient or outpatient facilities. The work there is very similar to that found in counseling or therapy work with families: The counselor forms hypotheses concerning the relationship structures and the communication processes in the group. He then checks them by means of circular questioning or sculptures together with the group, exploring solution fan-
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tasies and focusing on available resources. One can also use the interventions described in Chapter 5. In the second case, the goals and tasks are not concerned directly with relationships and sensibilities. This is particularly the case with groups of children and adolescents: – who share common learning and developmental tasks within an educational setting, – who live together in assisted-living facilities and need to overcome deficits, – who spend leisure time together and want to have fun together, make some new experiences and build competencies. But it can also be with groups of adults, such as – long-term teams carrying out common tasks, – work and project groups that must produce a certain output within a set timeframe, – groups that want to develop new professional, cognitive, social or emotional competencies. In these contexts, too, group members may want to temporarily concern themselves with the relationships and sensibilities present in the group. A contract is made accordingly, with the group using the tools described in Chapter 5. In the following, we describe how one can help such groups to solve the tasks at hand or produce the performance desired without such a contract but using our systemic perspective. When searching for appropriate working hypotheses, the leader of such a group should keep the most important criterion in mind: What can I do to put the group in the position to reach their goal? A number of hypotheses and interventions will lie within the specific context and discipline. We concentrate here on aspects that lie beyond such special context circumstances: – What social and psychological dynamics are necessary for such a group to reach certain learning, performance and developmental goals? – Which relationship structures might prevent the group from actually reaching its goals? – Which interventions can the counselor offer to support the conditions and structures conducive to success? In the following, we introduce some working hypotheses and possible interventions that have proved advantageous in practice.
4.5.2 Hypothesis: Too Little or Too Much Cohesion It is difficult for groups to reach their goals when there is little cohesion, i.e., when the interconnections between the individual group members or between subgroups are insufficient.
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Case example: The group is lifeless – few members spontaneously take part in the discussions. Some seem to be very reserved or even anxious. Many look expectantly at the leader whenever the conversation falters or difficulties arise. The leader has the feeling that everything depends on her, that she must carry the entire responsibility for the quality of group discussions.
This situation is characteristic for the outset of a new group. The leader must ensure that enough interventions are being offered to allow the members to warm up to the group and to each other. There must be sufficient interaction among the members to lead to a complete network of relationships. It is worth one’s while as a leader to take the time to create a strong network. In the future, this will positively influence the actual group work, its results and the overall satisfaction of the individual members. Within groups that have been together longer, too, the cohesion – i.e., the solidarity among the individual members and the resulting network – may be suffering. Here, it is paramount to offer methods that lead to more positive interactions in the group. Depending on the situation, this could mean – furthering the interactions of all members among themselves, – ensuring stronger interconnections between the subgroups, – better integrating the “rejected” or “unseen” members with existing subgroups, – intervening with more adequate moderation techniques to forge connections between the participants and thus to support the overall group structure. Of course, the opposite can also happen: that there are too many or too close network connections in the group. Here, the members are concerned more with the personal contacts emerging from the group and neglect the true task at hand: The relationship level dominates over the work or objective level. Case example: In a group of trainees the breaks keep getting longer. The group leader always has to prod them to get working again. The members stand around in small groups, talking and laughing, apparently getting along quite well, but the overall work results are meager. Presentations of their work results are accompanied by blasé remarks: “Well, we had a weak start and it went downhill from there!” The group is amused and doesn’t seem to be bothered by the situation. The mood is upbeat, and the group fails to notice the poor state of affairs.
In this case, the moderation structures must be changed in order to – re-center the group to the task, – allow the individual members to return to their original attitude toward the leader, – confront members with their respective performance level, – enable a debate within the group about the group situation. The goals may have to be recontracted with the group as a whole.
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4.5.3 Hypothesis: Destructive Group Dynamics The group is continually caught up in negative communication: – The same deprecative comments, actions and behaviors are repeated over and again, both between the subgroups and between individual members. – These disparaging remarks lead to individuals or subgroups failing to work properly or even considering leaving the group altogether. – Insults and attacks are observed and must be addressed. Case example: In a group of children the verbal insults and put-downs cause one boy to withdraw completely; he doesn’t even want to be in the group anymore. The group leader repeatedly has to intervene and clarify what happened and why and set new limits. Case example: In team conferences, two fractions repeatedly exchange derogatory remarks. Whenever the tasks are handed out, the two fractions never mix but stay among themselves. They work out in painstaking detail whether one fraction has worked than the other, who is responsible for mistakes, who didn’t clean up the kitchen again, etc.
Social systems are not “teachable”; we cannot pick and choose the dynamics of a particular group! And yet we have to work with each and every group. In the group situations described, it makes sense to use interventions that are capable of providing solutions and clarification on the metalevel, i.e., that address the relationships in the group and any conflicts present. To this end, however, an agreement with the group members is necessary – which is not always possible. Another type of intervention in situations of destructive group dynamics lies in stronger and stricter group leadership with a more definitive structure. Experience tells us that in groups with little structure, spontaneous group dynamics tend to dominate and override everything else; in groups with greater structure, on the other hand, there is little room for spontaneous group dynamics.2 Such groups can be supported by – pointing out that drawing lines is sensible and justified, – emphasizing the importance of the objective level and the results of group work, – making sure formal rules are adhered to, – formulating the contracts as binding and attending to their strict fulfillment.
2 Here again we can learn from research on group dynamics: In the 1950s, Bradford et al. (1964) conducted studies in group-dynamics laboratories, provoking a high level of group dynamics by having the group leaders be completely passive. They then observed the resulting situations with their sometimes extreme spontaneous group dynamics. This approach was later used in Europe, too, where such situations were used within group-dynamics seminars as learning arenas for personal growth and for working through one’s personal history and problems. Today, these methods have become outdated and are seldom used.
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4.5.4 Hypothesis: Too Few or Too Many External Limitations As in families, groups, too, can have too few external limitations, which hinders their overall functioning. Case example: A team has the task of preparing an assisted-living program within a larger organization. The team has to cooperate with other units both within the responsible organization (management, home for the mentally ill, daycare facility for the mentally ill) and with external partners (psychiatrists in private practice, state authorities, local psychosocial groups). The team members maintain these external contacts autonomously and quite intensively, whereas the internal contacts tend to be neglected. Cases are preferably discussed with the responsible physician and other helpers (such as legal guardians) rather than directly within the team. The team leader thus often learns about the activities of the colleagues when their applications have already been approved by management. The team members in turn wonder about their team leader who is so poorly informed about what is going on in the group. Case example: In a children’s home, there is often great turmoil among a group of 8 children aged 6 to 16 years. Children from other groups wander in and out. Some children in the group prefer being in other groups in the home; it’s “nicer” there, they say. The group doesn’t do much together. More and more often, children say they don’t want to take part in the group’s activities because they prefer other programs. In the past, this has always led to discussions and the caretakers ended up giving in to such requests because they didn’t want to force the children to take part in activities against their will. Quarrels also arise between the “guests” and the group members. The caretakers tend not to intervene because they want the children to learn to solve their conflicts on their own. The children complain about this and say they can’t assert themselves toward the “guests.”
In these situations defining and setting limits and establishing rules as well as controlling their fulfillment would help the group. Yet separating the group from its surroundings is not an easy task since not all members accept such boundaries. The absence of such boundaries carried with it great freedom for the group members – despite all the disadvantages. A clearer delimitation of the group is bound to be met with resistance, at least in the beginning. In the first example of the team in the assisted-living facility, it is recommended that clear rules about internal information processing be set up before information goes out – even against internal group resistance. One could, for example, agree that case reports first be presented in the group and further action be agreed upon there, before the case is discussed with anyone outside the group. In the children’s group it may be necessary to limit the bringing of guests into the group. Or one could set up a rule that a guest who causes problems with other children in the group has to leave the group.
Another sort of intervention in such systems is to work on rebuilding the identity of the system such that the members regain a positive attitude toward the system. Of course, this cannot be dictated. One can, however, encourage activities that foster and cultivate a sense of belonging.
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In the assisted-living team these might consist of regular case meetings that convey the importance of the work the group is doing. One could have advanced training together, have two colleagues work on a case together, praise successful work or go on excursions together. Sometimes, the best thing is simply to work together and develop common professional practices.
Boundaries that are too rigid or impermeable can have a similarly paralyzing effect. In Chapter 2.2 (What Is a System?, see Background Text) we talked about the idea of a half-open system as a model for social systems. Social systems need sufficient exchange with their environment to ensure functionality. Case example: A self-help group of former alcoholics has been meeting for years. At one time, the group was very important to everyone. They engaged in an intense exchange of ideas and feelings. Group members provided each other with mutual support for many years, seeing each other through many difficult personal and substance abuse-related crises. The group members bonded, and some were even spending their free time together. Over the years new members were added, but they never stayed in the group for very long: The chemistry just wasn’t right. It was fun being together and all, but the conversations weren’t all that exciting. Exchanging the same old stories in the same old ways was no longer solving any problems. Case example: The local brass band is a truly traditional club. The director and the musicians have all been there for a long time. The listeners at the spring, summer and Christmas concerts also seem to always be the same people. A few new pieces are worked in now and then, but the style and atmosphere remain the same. The musical development seems to have reached its pinnacle a long time ago. A friendly, committed group – but without a real future since there are no new recruits.
When the boundaries of a social system lose their permeability, there can be no more confrontation with the environment, inevitably ending in paralysis. The efficiency and the potential of any social system will always suffer after a certain period of time. If there is to be more traffic at the border, so to speak, then the leadership should be prepared to be met with resistance. Actions provoking more exchanges with the surroundings – introducing new things and new people – are absolutely necessary. They may, however, be sabotaged from within, since they also mean a loss of protection, security and intimacy for the group members. Fear of everything new and foreign, however, inevitably leads to seclusion.
4.5.5 Hypothesis: Different, Contradictory Values and Interests This is not another case of entirely negative dynamics within a group. There are some functioning subgroups whose members still like each other and get along quite well. Yet, between these subgroups and other members (who tend to be unseen or excluded) much rejection and disparagement is going on. A look at the social and psychological dynamics shows that the values and interests are very different, in part even diametrically so.
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Case example: In a group of long-term unemployed persons training to reenter the work force (at a catering company), two subgroups have emerged. One group consists of four women, the other of three men. A further man remains an outsider to both groups. The members of the subgroups all have histories of failed personal relationships. Some of the women have been abused in the past, and male macho behavior puts them off and provokes them. The men tend to be very macho and feel cheated and financially exploited by the women in their lives, most of whom they no longer see. The one excluded man is younger than the others, is homosexual and a member of the alternative scene. He’s a red flag for everyone else, whether male or female. The mood in the subgroups is irritable. There is much bickering and aggressive exchanges of words.
With this kind of working hypothesis, the group leader has a number of possible interventions that would support these groups: – Within the group as a whole, the leader could loudly and firmly declare that differences must not be met with a go/no-go stance but rather be accepted as existing side by side. In this vein, the leader must provide positive feedback for the value systems of both the subgroups and the outsider. – It is recommended that the structure-free sequences of group work be kept very short. Otherwise, too much space is left for spontaneous group dynamics, which may lead to escalations which endanger the fragile group cohesion. – The leader uses forms of moderation that provide each subgroup with the opportunity to develop activities that reflect their respective interests and values in order to stabilize the group. The group as a whole can then once again come together after such phases. – The leader makes theme-based offers, requests or work tasks that are not clearly oriented toward any specific interests, competences and value systems of any one of the subgroups or outsiders. This provides a way to nurture new social constellations. – The leader can positively address the interests and value systems of any outsiders – as long as it remains authentic.
4.5.6 Hypothesis: “Alpha” Stands for the “Wrong” Values and Interests The following group situation exemplifies a further form of impediment to group functioning. It is best explained using the model by Raoul Schindler (1957; see also Background Text on Chapter 3.5, Figure 19). In this model, the rank position of the “leader” (Alpha) has a special meaning to the group. This person is best able to organize and transform, into word and action, the needs that are present in the “tag-alongs” (Gamma). Those in the Gamma position are followers who support and sustain Alpha’s actions since they correspond to their own needs. Yet sometimes Alpha’s norms, values and actions contradict and thus impede the true objectives and tasks of the group. Having a person with this degree of impact
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and such important function in a group system can thus endanger the success of the whole group. Case example: In a group at a home for adolescents there are problems with Peter (15 years old), who is liked and esteemed by the others and who sets the tone of the entire group. His suggestions are usually quickly agreed to by the others. Unfortunately, however, he also has a knack for deviant behavior (stealing, small-time extortion, violent reactions). Yet he vehemently defends his behavior as being “cool” and bold. This includes listening to the right music and wearing the right clothes. The younger boys in the group imitate him. A few other boys, who are not so “cool,” become outsiders: Their way of dressing and acting is put down. Peter also puts down the counselor by loudly making it clear that his friends on the outside who drive good cars and have more money are simply “cooler.”
Reaching the set goals in such as group means first resolving the conflicts with the Alpha member. The group leader has to stick this conflict out; and not let the values and opinions of the Alpha member triumph. Here are some possible interventions: – Support the outsiders and check whether their strengths and values might someday be good alternatives to the direction the group is presently taking. – Create situations and chances for those members in the Beta and Gamma positions to bring their interests to the forefront – even if they do not correspond with those of the Alpha member. Also, strengthen and support such aspects. – Avoid situations and structures where the Alpha member can take center stage. – Do not avoid direct confrontations with the Alpha member and demand that respect be paid to your position as group leader. – Insist on apologies when insults and put-downs are expressed. Excluding the Alpha member from the group, even if the conflicts have not been completely resolved, is the action of last resort. Nonetheless, this solution is preferable to one where the group leader offers the group support while having to deal with destructive impulses that threaten to torpedo the group goals. Such a situation can be a tremendous trial for any group leader and demands complete commitment to the group and the task.
4.5.7 Why Develop Such Normative Hypotheses? In the Background Text in Chapter 3.2 we were concerned with normative systemic approaches. Common to all normative approaches is that they describe the conditions in a social system that lead to successful communication as well as to positive development in children and families. Our working hypotheses for groups that have learning and work goals and no contract for relationship tasks are normative in a similar sense. They presume groups to be social systems that have their own social and value-oriented structures that can be implemented for productive or destructive purposes. As group leader, it is worth one’s while to construct hypotheses about the structures which
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impede or further the success of the group. Our experiences with groups permit us to differentiate between functional and dysfunctional structures in families, too. Leading a group means having the authority and the possibility to aspire to desirable structures. Clearly, complex social systems such as groups are not teachable. A certain type of intervention does not necessarily lead to a certain state of affairs – regardless of how diligently and carefully one prepares it. There are always persons in such a group who decide differently. Thus, when working with normative hypotheses we should beware of becoming annoyed at the system when our wonderful intervention ideas fail to catch on in a group. Rather, treat this as an indication that one has yet to find the proper gateway and needs to rethink the hypotheses.
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The various traditions of systemic therapy and counseling, have led to a multitude of different methodological approaches. There have been heated conference debates over which method best fits systemic-constructivistic concepts, for example, whether directive interventions could be combined with the necessary respect for autopoiesis (the self-organization qualities of a system). One aspect is usually overlooked here. It is that which one would actually expect systemic practitioners to have a particularly good eye for: the context in which a method was developed. That is, the clients, the culture, the institutional background and, of course, the therapist with his or her own history and preferences. Which variations are useful depends greatly on the context: When working with a well-structured, more or less stable family it may be appropriate to shake loose some of the stalemated opinions and behavioral patterns, to interrupt the normal run of events, trusting that the family will – autopoietically – grow new legs to walk on. In a family from a marginalized social group or a slum-dwelling family that has been upset by many other factors, one may first have to provide support, protection and structure – which means introducing a more directive intervention. That, by the way, was the background to Minuchin’s structural concepts (see Families of the Slums, 1967, and the discussion above). Of course, a critical discussion of methods is always appropriate. Yet we suggest applying empirically pragmatic and ethical criteria first, before turning to more theoretical and esthetic criteria when weighing the options: What works in what context? Which methods correspond with one’s professional ethics and are defensible against the background of social and cultural ethics (of a particular country, religion, region or family)? These are short and somewhat simplifying comments, to be sure, but the conceptual framework of this volume forbids a discussion at greater length. We thought it important to elucidate where we are coming from when we choose and evaluate our intervention methods. Milton Erickson’s suggestion has provided us with important insight: One would theoretically have to invent a new school of therapy for every individual client, since every client is unique (Gunther Schmidt, personal communication, 1991). This perspective is shared by Klaus Grawe (2000) and forms the basis of his studies on the functional factors of psychotherapy. Being open toward the interventional practices of various schools does not, however, mean picking one’s method of intervention arbitrarily or randomly. First off: what works is good. We can continually learn from our clients and our experiences with them how to reach them best and which of our suggestions lead to constructive changes. Second, we have developed six criteria for choosing interventions which any systemic therapist would be able to apply:
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– Always act so as to increase the number of options: We have extended this moral imperative of constructivism (von Foerster, 1988, quoted after von Schlippe & Schweitzer, 2007, p. 116) in terms of organizational development (Glasl, 1983): Always act so as to increase the self-organizing capabilities of the system. That is, when intervening ensure that the clients (and the counselors) become more capable of acting and more open to options through their work. This also means intervening only when necessary to provide truly relevant support and to avoid creating dependencies and blocking self-help skills. – Contextualize problems and solutions: We should never look only at the individual, but also keep the context in mind – the individual’s living environment. Try to view problems in their present or past context. Regard them in a positive light as attempts at solving current problems, and as coherent implications of earlier life experiences (see Chapter 5.4.3: reframing). When considering interventions, try to weigh what effects they would have on the client’s surroundings. – Resource orientation: We should assume that our clients have resources at their disposal, albeit sometimes forgotten or deeply buried, the victims of hypnotic amnesia so to speak (problem hypnosis). Recovering these resources may in itself prove to be an important perturbance of the worldview of persons afflicted by problem hypnosis. Study previous reports and actions for signs of these resources and point them out to the clients. – Solution orientation instead of (or in addition to) problem orientation: Instead of the normal focus on problems and deficits found in person-centered therapies, work to find solutions. Anyone who can describe the problem accurately also knows the solution, at least implicitly: It is impossible to perceive a problem without at least having an inkling of how it could get better. Vice versa is also true: If we speak about what we are striving for, we are implicitly addressing the problems we’d like to leave behind. – Respect the autopoiesis of the client system: As counselors we are always dealing with living systems, not with machines (sensu von Foerster, 1984) that react to pushing a simple button. That means being curious and open to how the clients react to the interventions – even if we already have years or decades of experience and think we know how an intervention works. We can learn from the reactions of the clients, whether they are surprising or even unpleasant to us. Consequently, we view the practice of intervention as a process that occurs in cooperation with the client. The clients are the experts on their life and decide which path is best for them – but must also bear the responsibility (see Chapter 4.2). – Induce the new: Our interventions are aimed at change. To this end, we should introduce new ways of seeing things (perception), of interpreting things (cognition, mental models), of evaluating things (emotion) and of behaving (action).
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Background Text: Inducing the New – Where Does Change Begin? This criterion marks the differences in the convictions of systemic practitioners: What is the ideal path to inducing change? At which of the four corners of the circle shown in Figure 25 do we begin if we want to create the greatest and strongest impulse?
Figure 25: Action regulation
The way these stages are depicted in the model suggests a clarity that in fact is not present in actual behavior, where the processes lie much closer together. What we perceive and the meaning we ascribe to our perception, how we feel about and then act upon it – all of these factors depend on our mental models, which represent the essence of all our previous experiences. And these mental models, in turn are formed, changed and adapted by our experiences with our environment. We are advocates of being capable of acting in all four areas: be it via language games, via surprising reinterpretations, by working on our concrete behavior or by investigating emotional values. Systemic work also comprises interventions in everyday practical areas, the direct restructuring of behavioral patterns and modeling of behavior in real situations. We can introduce something new and different on the action level and be certain that the meaning we give it – our appraisals and our perceptions – will change along with our changing experiences. In the same way, we can induce change in actions by influencing interpretations. Recognizing system patterns, absorbing information, introducing differences or inducing change in a system can all occur on different levels: – virtually, by using querying techniques and the resulting descriptions, – metaphorically, by using sculptures and other forms of symbolic interaction, – directly, by using interaction and working with existing scenes,
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– indirectly, by supplying the clients with tasks and listening to the reports of their experiences.
Where we begin ultimately depends on the parameters present and the preferences of the client system – and on our own mental and action models with which we feel at ease and with which we were successful in the past.
Background Text: Solutions Are Important – and so Are Problems Solution-oriented approaches according to de Shazer (1985) often propagate blocking out any mention of problems altogether. They point out that problems are inherently present every time one mentions the solutions, and that strictly focusing on the solutions allows one to achieve changes faster and more elegantly than by constantly contemplating the problems. We can support this view in many ways, although we think one should continue to name problems and deal with them as part of the systemic approach. It is our observation that in therapeutic and particularly in corporate contexts, there is sometimes a potent fear of discussing problems outright. Many participants avoid the word like the plague and instead prefer to speak of “challenges” or that they are facing a “major learning opportunity.” Such talk can seem funny, or ludicrous at times – and it is quite doubtful that the mere renaming of a situation will really lead to rethinking. Often, this avoidance approach leads one away from normal, colloquial language, sounds strange and foreign, and above all creates an ironic distance from yet another set of rules of terminology. Rather, we think it is more important that clients who are experiencing problems be recognized and accepted as such. A woman who has been abused in her family and was never allowed to talk about it must first get some space to speak the unspeakable, to “tell it like it is,” and to experience her perception of events as valid. For us counselors and therapists this means talking about problems that burden and upset the life of the clients and validating them in order to then focus on how to alleviate them. A further aspect: Clients who have lived with, and suffered from, their problems for a long time should develop an understanding of the meaning of their anguish and a sort of self-appreciative. This is especially important in cases where a long-standing problem was resolved in a relatively short timespan through therapy or counseling. What effect did this have on the self-esteem of the client? How is the client coming to terms with the fact that, for a long time, he or she was unable to solve the problem and then suddenly it was solved so quickly? We find it important to honor the problems, as it were, by naming them and – if appropriate – by giving them a positive spin. We work together with the clients to determine what role the problematic behavior had in their lives and
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to understand why it was important. In this context, Antonovsky’s (1987) studies on salutogenesis are useful, and a source of inspiration. A medical sociologist, Antonovsky studied how women of various ethnic groups living in Israel adapted to menopause by collecting extensive data on their mental and physical well-being. He also asked whether the women had been in a German concentration camp: It turned out that 29% of the former camp inmates in his sample reported a good mental and physical status. “Having survived the unimaginable horrors of the camp, having been a displaced person for many years thereafter, and having then started a new life in another country that itself experienced three wars . . . and still be relatively healthy! That for me was the most dramatic experience that consciously showed me the path to formulate what I later called the salutogenetic model and which I published in Health, Stress and Coping” (Antonovsky, 1987, p. 15).
In this and further studies Antonovsky asked whether there are patterns, behavioral tendencies and attitudes that could explain why some people can live a healthy and stable life following extreme traumata. The studies resulted in three factors that were repeatedly found more in traumatized but healthy and stable persons than in traumatized persons suffering from various mental and physical problems. Comprehensibility: This means the ability to integrate events into their life, to find explanations for what has happened to them. People who can incorporate the events into the context of their life can cope with traumatic experiences better than those who fail to see their life in this way. Manageability: People who have discovered in themselves the resources to act under difficult circumstances can better cope with traumatic events than those who see themselves as helpless victims. Examples are camp residents who played music with others, gave art courses to the children, helped their fellow sufferers or organized the resistance movement. They were all searching for some tiny way to act and react under unimaginably horrible circumstances and to use them to the best advantage. Significance: The factor that is perhaps the most difficult to understand with respect to the Holocaust is the ability to give meaning to what happened, to lend it a personally meaningful interpretation. This concerns the emotionalmotivational side of human experience: Anchoring one’s life within a meaningful context seems to contribute to people’s overcoming their traumatizations. There were apparently a number of people who were able to gain meaning and strength from their religion, their political convictions or their humanistic values even under the worst of all possible circumstances. Antonovsky worked these insights into a comprehensive concept of how health develops and is maintained (literally: salutogenesis). If we attach great
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importance to these lessons, then we must also take seriously the client’s view of his problems. It would, however, be wrong to dwell on it. Rather, the experiences gathered with solution-oriented approaches provide much evidence that they can, above all, serve to trigger change.
Two approaches from the past few years include seminal concepts which provide systemic actions with better orientation: synergetics and the generic principles of systemic therapy derived from synergetics (see Schiepek et al., 2001; Haken & Schiepek, 2010). During a DGSF congress in 2005 in Oldenburg, Germany, Günter Schiepek presented his vision of future theoretical and methodological developments in the therapeutic and social fields. He started from a systemic metatheory that describes theoretically the development of systems – and thus also deals with how problems (and their solutions) arise in systems. In his other publications (see Haken & Schiepek, 2010) he suggests using synergetics as the theoretical basis for this metatheory. The theoretical model of synergetics is one of self-organization, created to explain the structural and change processes in systems. The inventory of methods available for concrete interventions is large and draws on all existing traditions of change induction in human systems. Drawing on the results of past and future research, we will be able to narrow down the choices to those methods that are the most successful. The main criteria for this selection will be efficacy and compatibility (with the client system and the counselor’s predilections). An action theory supplies process models that can inform us how and in what order the various methods can be applied to construct change. For this purpose, we can apply the generic principles from synergetics to guide our actions. They can be viewed as checklists and quality criteria which guide the design of concrete processes and the application of methods. The describe the prerequisites of successful change processes in self-organizing systems: – Creating the conditions for stability: Creating emotional security and trust, setting up structures and frameworks, supporting self-esteem. – Identifying the patterns in the relevant system: Identifying the relevant system for the intended change; observation, description of system patterns. – Establishing and increasing connotation and synergism: Determining and supporting the meaningful evaluation of the change process by the clients; relevance to lifestyle, personal development tasks, lifecycle, etc. – Finding control parameters and enabling energetization: Creating conditions that further motivation such as relevance to the goals and concerns of the clients; discovering what themes are most important to the clients and incite the greatest motivation for change. This, in turn, means: activating resources and making them available for the task at hand.
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– Destabilization, strengthening fluctuation: Identifying existing fluctuation and incipient change within the system and using it; experiments, breaking up patterns, introducing differentiation; emphasizing exceptions and existing suggestions for solutions. – Resonance/synchronization: Coordinating therapeutic action with the mental and social processes/rhythms of the clients; paying attention to time concerns. – Enabling direct interruption of symmetry: The donkey that can’t choose which of the two piles of hay he should eat first lives in a symmetric balance – but still dies of starvation. If he wants to eat, he has to first make a move and forfeit balance and symmetry (to quote Satir: “You can’t move a boat without rocking it”). This means orienting oneself to goals, anticipating and realizing new things and motivating clients not to sit still. – Restabilizing: Welcoming new behavior means practicing it, seeing to it that new cognitive, emotional and behavioral patterns can become stable.
These eight prerequisites can be put in relation to the studies conducted by Klaus Grawe (1999). His metastudies on the courses of various forms of psychotherapy were aimed at determining which factors of the different schools of psychotherapy correlate with successful outcomes. The functional factors he found can easily be extrapolated to other psychosocial fields that deal with the development and modification of human behavior and human systems. According to Grawe, the following factors must be present to ensure good psychotherapeutic results: – Relationship and cooperation: This refers to the counselor’s commitment and efforts to establish contact and trust with the client, the counselor’s “joining” (see Chapter 2.4.2). It includes perceived competency (do clients feel they are “in good hands”?) and the client’s cooperation. – Resource activation: Positive goals are named and promoted, existing skills are recognized and used, new ways to cope are latched onto and tried out. The clients feel validated, their personal strengths are discussed and incorporated into the counseling process. – Actualization of problems: Problems are not only named, but also activated and worked on extensively within the therapeutic process. This factor underscores the importance of enactment or in-vivo-work and the stimulation of emotion. – Orientation to change: The focus is on change, and confidence emerges; for solution-oriented systemic therapists this is a clear confirmation of their method. – The experience of clarification: Relationships become clearer during the discussions, the clients outline a consistent picture of their strengths and their problems. Sometimes just sorting out the situation and developing new ways to look at it can provide great relief, allowing clients to find their own solutions with the help of the counselor. – The experience of coping: The client has a sense of success and achievement in counseling. The client can now autonomously and successfully shape areas of life that were previously experienced as problematic or adverse – and receives proper feedback on these efforts. This emphasizes the importance of prudently
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topic selection (see Chapter 4.4.4): What theme promises quick initial successes and thus can provide energy for the next steps? Which problem can serve as a vehicle for further learning experiences that can then be applied in other areas of life? This list illustrates the close relationship between the various factors derived from different schools of psychotherapy and the action concepts of systemic theory. In the following, we present different forms of intervention that have been developed in the systemic and other traditions. We consider them useful in our practice for a broad selection of psychosocial and pedagogic fields. The interventions presented above all share more or less the same goal: changing relationships in systems. Yet we must voice a warning: These interventions should not be applied without the respective mandate and contract from the clients! Such a contract may be present in many cases, but in others this is not automatically the case. Because of our training and competence we can spot any problem in the system. Or we are part of the system and notice that it is not running as smoothly as we thought, yet don’t have an explicit mandate to intervene. In such situations self-restraint is the best method of intervention! Intervening without a contract produces nothing but trouble and rejection, no matter how good our intentions were. Case example: As the leader or a member of a team, you notice that things are not moving forward. Nevertheless, do not begin asking circular questions without first having made the suggestion and having received everyone’s consent. Case example: In a rehabilitation group for alcoholics a massive conflict between two members is blocking progress. But without consent and mandate, one should not prepare a sculpture of this conflict. Case example: In a parent-teacher meeting at a nursery school a conflict breaks out between the two parents. One is convinced of being able to help them with just a few circular questions. Still, one should first get their permission to work with them on this problem. 5.1 Sculptures:Three-DimensionalMetaphors
5.1 Sculptures: Three-Dimensional Metaphors Working with sculptures means describing the perspective of individual clients not with words, but rather physically and spatially. The term “sculpture” is fitting, since it describes how the counselor, like a sculptor, symbolically depicts to someone their relationships in three-dimensional space. This can be done statically, with movement, as a pantomime, or with words and sentences. The different methods also include such terms as formation, family lineup or choreography. The differences lie in the way they are executed: – When we use strong, expressive means (gestures, facial expressions, sentences, differences in height/distance) we speak of sculpture.
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– Formations or family lineups are based on the dimensions of proximity and distance, affection or aversion. – A series of movements used to symbolize experienced relationships (relationship dances) is called choreography.
Sculptures have a long tradition in systemic theory. Many of the early, eminent pioneers, teachers and authors broke important ground on this matter (e.g., Duhl et al., 1973; Papp, 1977, 1996). Especially Virginia Satir shaped this method of body- and movement-oriented work and made it popular. We can draw on her experiences – and do so all the time! Sculptures are sometimes more effective than working with language: They are valuable diagnostic tools for both counselors and clients, and represent efficient methods of intervention as well. This chapter has two goals: First, we want to provide anyone learning (about) systemic methods with concrete directions on how to use them in practice. Second, we want to encourage readers to leave the security of their armchairs and their verbal skills and to enter into another field of action. Our practice shows that sculptures are often used – but all too often only very statically. This tool has many more untapped possibilities. Thus, we present some additional creative angles that lead to a greater breadth of experience. We also wish to demonstrate the connection between language-based images and scenes. A sculpture can depict many things: – external relationships in systems, – developments of systems over time, – clients’ internal scenarios. In this chapter we discuss the first two possibilities. We exclude sculptures that represent clients’ internal scenarios because we want to stick to tools that may be used in social systems. Examples for presenting internal scenarios via sculptures are Virginia Satir’s “Parts Party” (1988) and Gunter Schmitt’s “inner team” (2010, p. 195).
5.1.1 Sculpture as a Metaphor for Relationships Every sculpture needs a sculptor who reproduces his or her own take on things. We differentiate between three different ways of working with systems, each of which confers a special meaning upon the sculpture in spe. Inside-out sculpture In this variation a member of the system is asked to give his or her view of the existing relationships. The counselor decides which member to choose for this task. He should aim for someone who seems highly motivated and possesses the greatest creative potential or ability of expression. Often, adolescents are a good choice, or system members who are not so closely involved in the “dance about
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the holy symptom.” Then again there may be situations in which the actual “symptom carrier” can best assume this role. There is no set rule. Once a sculpture has been created, creating another one becomes easier: The first sculpture breaks the ice for a new and unfamiliar medium. An inside-out sculpture encourages the system members to accept, understand and feel the experience of one of their own. Such a depiction can be intensified by offering the individual members the opportunity to assume different positions, to change their perspective and thus to understand the feelings expressed. Some members may want to correct the sculpture since it does not correspond with their own experience. This should be addressed in order to induce discussions about differing points of view. Again, we must emphasize that there is no correct or incorrect way of looking at a system’s relationships, and thus no right or wrong sculpture. Here, too, it is always a matter of views existing side by side, rather than being mutually exclusive. Moreover, it is exciting to look at the various images one next to the other. Too many images, however, can overtax the group. It is our experience that one need not stage multiple, and certainly not all, positions. Outside-in sculpture Here, the counselor shows the system his or her view of the relationships in the form of a sculpture. Virginia Satir liked to use this method to make clear to families how she saw their communication patterns. She often introduced the creation of such sculptures with the sentence: “I want to show you something.”1 Satir says that the sculpture clearly represents her take on what is happening in the system. She invites everyone to contradict her if they don’t agree with her way of seeing things (Satir & Baldwin, 2008, p. 48). Within the scope of the structural approach, such outside-in sculptures can be used to demonstrate dysfunctional structures. For example, coalitions between a parent and a child, unsolved hierarchy boundaries or split parent subsystems discovered by the counselor can be depicted realistically and impressively. Case example: A family living in separation with two daughters (13 and 8 years) comes to counseling because the older daughter is increasingly having conflicts with the mother and her new partner. She is having trouble sleeping, withdraws socially and neglects her athletic interests. The parents split up about 4 years earlier. The children spend ca. 60% of their time with the mother and 40% with the father. The topic of the second session is the children’s visits with the father’s parents. The mother criticizes the form and frequency with which the father takes the children with him to his parents’ house. The parents include the children in the discussion. The older daughter says she thinks the mother’s position is wrong and exaggerated. The younger daughter says she doesn’t really care; sometimes it’s too much for her, but she does like seeing her grandparents . . . The father’s eyes light up and he smiles slightly when the older daughter confronts the mother. He himself says little, however, and 1 Gaby Müller (2002) points out the almost ritualized nature of this introduction.
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reacts calmly to the mother’s accusations. The mother becomes more and more helpless and aggressive and increases her attacks. The counselor offers to create a sculpture to represent how he sees the family. He puts the mother and the father at a distance of about 4 meters from each other. The father has his arms crossed. The mother takes one foot toward the father and shakes her fist at him. The older daughter stands near the father, in front of him, protecting him halfway from the mother, both hands provocatively put on her hips, looking toward the mother. The father and the older daughter are so close that their bodies touch slightly. The younger daughter is sitting about 1 meter from the mother on the floor, slightly off the axis between father, mother and the older sister, so that she can look back and forth between them. After the family stands in this sculpture position for a while, the parents agree that this is a typical depiction of many interactions between them. The mother’s new partner always stands behind her and supports her. It is also typical that there is no real argument between the parents, but rather between the older daughter and the mother. The sculpture brings into visible form some of the interactional patterns for all to see: – the dysfunctional coalition between the father and the older daughter, – the diversion of the parents’ conflicts to the conflict between daughter and mother, – the surrendering of sufficient solidarity of the parental subsystem.
The clients experience the patterns staged in the sculpture very intensely and are subsequently able to recognize them in everyday life. This, in turn, increases the chance that they will indeed try to interrupt the patterns. Simultaneous sculpture In a simultaneous sculpture there is no single designated sculptor, but rather all members of the system have the job of finding a place in the room that symbolizes their position in the system. One can use gestures, facial expressions and line of gaze as signals. All system members move slowly, at the same time, reacting to the other members and their positions, gestures and facial expressions. Changes in one person’s position lead to changes in the others’ and vice versa. It takes some time until the system arrives at equilibrium. This entire exercise unfolds as a very exciting and meaningful dance by the whole system. The dance in itself usually contains a wealth of inspiration for exchanges about the members’ relationships. Case example: A team supervision session focuses on cooperative relationships. The topic was brought up due to the uncertainty some members feel regarding their position within the group as well as the nature of the expectations directed toward them. A very lively discussion ensues, but again and again statements are modified, qualified or accompanied by lengthy explanations. No clear picture of the overall situation emerges, and the discussion threatens simply to peter out without any results. The members also show a certain weariness and strain in reaction to the wealth of statements. The counselor suggests forming a simultaneous sculpture. This switch from word to pantomime brings about new tension. But its realization takes some time since there is much fine-tuning to be done. One witnesses a silent negotiation process, whereby the positioning going on reveals more than the all the words previously spoken. The sculpture forms a good basis for the resulting exchange about what the positions mean for cooperation within the team.
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Classification questions are also suitable for simultaneous sculptures, by spatially arranging within the room the responses to a particular question (see the simultaneous sculpture in Chapter 5.3.1). Setting up a sculpture – step by step We suggest a sequence of steps for setting up an inside-out sculpture. This may seem rather mechanistic and rigid, and it is certainly not the only way to arrive at an excellent sculpture. But our intention is to offer the readers a framework for creating their own sculptures – and to urge them to put this knowledge to practice. 1. First we must sort out with the sculptor what is to be the content of the sculpture. Besides those persons present, other relevant persons can be symbolized by chairs or other objects. Sometimes even areas of life or institutions can become part of the sculpture. Case example: During the counseling of a family, the 12-year-old son positioned his father as standing somewhat off to the side, gazing into the distance. Asked what he thought the father was looking at, he said his father was looking at his work. The desk in the room was then incorporated as a symbol for the father’s work. The sculpture thereupon took on a sort of tension stemming from the axis father-work, which apparently was a major part of family life for everyone present. 2. The sculptor can also specify the distance between figures to symbolize the closeness of relationships. In the same step, the sculptor can specify the line of sight between the figures. To support the sculptor in this work, we suggest stepping back from time to time to look at the sculpture as a whole. Sculptors who themselves are part of the sculpture can temporarily use a chair to represent their position. 3. Now we introduce the dimension “up-down” as a symbol for differences in influence. Figures from the sculpture stand or sit on chairs, others kneel or squat down, or sit on the floor. Now, at the latest, anyone present in the sculpture should be asked to note their position and posture so that they can relax every once in a while and avoid having to hold out in uncomfortable positions for long periods of time. 4. The next step adds facial expressions, gestures and posture as expressions of the quality of relationships. Some participants may need some encouragement not to be afraid to act out some tabooed aspect of the relationship. As counselors we should repeatedly emphasize that we are experimenting, testing perceptions – not depicting reality. Nevertheless, we should ask the actors – particularly when they have assumed a critical gesture or body position – whether it is OK for them to take this position for the sake of the experiment. We must also keep in mind that is is our duty to protect the actors and to keep pointing out the symbolic, playful nature of such a sculpture to avoid someone being offended. Case example: While setting up a sculpture to depict the relationships in a team, the sculptor (a woman) had a (male) colleague stand on a chair to rep-
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resent the considerable informal power he enjoyed. She perceived another (female) colleague to admire the male colleague professionally and personally and to be oriented toward as well as dependent on him. Thus, she positioned her on her knees to his side. The counselor thought it important to interrupt at this juncture to point out the subjectivity of the viewpoint and the symbolic character of the sculpture. He asked the (female) colleague if it was OK for her to take this position for a moment to see what sort of image resulted and what feelings and changes would then be important to her. 5. If we want to further increase the emotional qualities of the sculpture, we can ask those populating the sculpture to raise the level of their gestures, position and expressions – to exaggerate. Another possibility lies in asking the sculptor to assign to each figure a sentence that spontaneously appears pertinent. The sentences for the various figures need not be coordinated, rather the sculptor goes from figure to figure and says the sentence considered to be relevant to that person. 6. Once the structure has been completely set up, the “players” are given a certain amount of time to get a feel for the sculpture and their own respective position in the sculpture. Those involved should stand still for a couple of minutes and concentrate on their own experiences and perceptions. When working with sentences (see above), the players should repeat them aloud in the room over and over. This is most effective when the sentences are spoken one after another and not all at the same time. In this phase, which can be one of great tension, stress and emotionality in the group, clients have the tendency to talk a lot, laugh or make jokes to relieve the pressure. This, however, causes the emotional and physical effects to dissipate so that the counselor may have to intervene and reestablish everyone’s concentration. When accompanying sculptors it is important to discover how much support or freedom they need to release their own creativity. The counselor should remain close to the sculptor during the sculpting process and then leave the scene once in a while to stand off and observe the sculptor’s actions. This gives the counselor a feeling for how much guidance and structure the sculptor needs in order to express his or her viewpoints by means of the sculpture. As a rule adults tend to introduce their point of view less by manipulating distances, lines of sight and facial expressions and more by the use of verbal descriptions. One should ask them to refrain from using words to describe their viewpoint but rather to create a picture, to lead the individuals to their respective spots without the use of language and to “form” them directly or, if that is awkward, by posing to show them how to stand. After all, a real sculptor doesn’t write an essay but creates a sculpture. Follow-up after sculpting Once the sculpture is finished and everyone has had enough time to look at and understand what was created, the next step is to evaluate it verbally and nonverbally. Here are some suggestions on possible ways to follow-up.
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Taking in the whole sculpture from different perspectives Members of the system each get the chance to look at the sculpture from the outside – to walk around it and take different perspectives. They should consciously regard it from the outside and slip out of their own position within the system. Another person or a chair can take their place in the sculpture during this time. Ask the external observer to imagine seeing this sculpture in a museum of modern art. Members of the system can also assume the position of others, exchanging roles in order to realistically experience others’ perspective. This change of perspective provides new ways of seeing and experiencing things, and it supports clients in finding new solutions. Dance The actors in the sculpture can slowly carry out any movements they are feeling in their current position. The others are requested to react to these movements, but only slowly. Thus, a sort of pantomime or dance occurs. Its nonverbal nature can lead to clear and poignant images. Connections and interactions become better distinguishable since expressing such processes verbally can be too complex or difficult because of their unconscious or semiconscious nature. Slow-motion morphing to a favored position One member of the system can also express her own desires by changing her position. She can do this by moving in slow motion to the desired position and perceiving the change this brings about. Everyone else is requested to react in slow motion and without words. This makes clear what the solution is for an individual member and what forces act against this solution. Taking a step toward one’s favored position: What I need to do differently If members change their positions in the sculpture toward some other, more desired positions, the counselor should ask them to call out what else needs to change in order for their wish to become reality. A variation thereof is having the other members suggest what that person should do when taking a step toward a desired position. The system’s ideal sculpture All members of the system move slowly to their respective desired position and react to the movements of the others, as described in the simultaneous sculpture. A change for the future and what will happen Here, too, as with circular questioning concerning future changes (see Chapter 5.3.2), the counselor points out future events or developments. As in a simultaneous sculpture, the counselor asks everyone to change their respective positions so as to represent how future relationships would look. Or, in the sense of an inside-out sculpture, the counselor asks one member of the system to depict the
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future situation and how the event might change the relationships by reshaping the sculpture. Case example: A family with a 16-year-old son and an 18-year-old daughter seeks counseling because of the frequent quarrels with the children, which in turn leads to quarrels between the parents. In the daughter’s sculpture the children stand close together and look both toward the parents and toward each other. The father and the mother stand on different sides of the sibling subsystem; both are looking toward the children. The father has one hand on his hip and makes a threatening gesture with the other hand. The mother offers the children one hand and waves a warning finger with the other. The father and mother stand far apart and do not look at each other. The counselor asks the children to slowly withdraw from the line of sight between the parents. With every step the children take the parents should offer the children something. After a few steps the parents become uncertain about their positions and say they feel unsure about what things will be like for the two of them. They move toward each other but fail to find a suitable position. Eventually they give up, and it remains unclear how things can proceed. The sculpture changed the focus of the session. It was no longer about the disputes with the children and between the parents but instead about letting go of the children, how the children can leave the family and take on responsibilities of their own. In the subsequent conversation the parents discover that they are in agreement about many points. The gap and uncertainty in their togetherness has also been perceived and labeled.
This method can also be applied when working with families seeking to take on a foster child. After setting up the present situation of the family, the counselor asks the prospective parents to position a chair (with a doll/stuffed animal on it) to represent the new child in the family. Where is the child’s position? Who has to change positions to accommodate the child? Who has to change more, who less? What do the individuals think about this? Feedback One can also give the sculpture verbal form by asking each individual to express – what he or she saw in the sculpture (thoughts, images, feelings, bodily sensations), – how closely the sculpture corresponds with everyday life, – whether or not any new ideas emerged while looking at the sculpture, – what the consequences of working with the sculpture might be. Sometimes it is important for the clients to sort out verbally what they intuitively experienced. The counselor’s own observations can be important comments on certain details (respiration, delayed movement, physical tension) that escaped the notice of the system members. Once these are mirrored, they often make sense to the clients and inspire self-exploration. During verbal evaluation the counselor should decide how much of the results and processes to translate into rational, analytic thinking expressed in words (see the Background Text below). Some counselors prefer to allow considerable space for such verbal translation, others waive this possibility altogether on the assumption that what happens in such a session will have consequences for the client’s viewpoint
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and behavior no matter what the counselor has to say about it. It is our position that both paths can be true and meaningful, depending on the situation, the system, the problem at hand and the way the counselor prefers to proceed. Background Text: The Value of a Sculpture The linear logic of language: Circular descriptions via metaphors Schweitzer and Weber (1982) describe this aspect of working with sculptures as follows: “Researchers developed the theory that there are two types of ‘knowledge’ and two types of mental processes leading to knowledge: left- and right-hemispheric knowledge (Ortenstein, 1972; Samples, 1966). The left half of our brain is responsible for the anatomic correlate of linguistic-logical thought, which divides up reality into its individual parts, puts linguistic labels on them, and then puts them back together according to the rules of syntax and grammar. Right-hemispheric thinking, on the other hand, happens in whole images, in metaphors, on a more intuitive level, without separating the elements of these images into details and cause and effect chains. Family therapists are usually people who, over the long course of their formal training, have intensively learned to use logical, analytic processes rooted in the medium of language. When they begin to work with families, however, they are confronted with a dilemma: Family processes, like all processes in life, occur simultaneously, holistically and circularly. That is, many processes in the family occur at the same time and side-by-side within the family. Every single event has a meaning only within the context of other, synchronous events. There are no isolated cause and effect relationships; rather, one process is at once the cause and the effect of other parallel-running processes. When the family therapist puts what he has observed into language, he necessarily must punctuate his narrative, dismantle the relationships and later reorder them once again. This is not amenable to the nature of a living system. But instead of describing these processes serially, he can capture them in a sculpture, in a film or even in a dance in all their simultaneity and circularity.”
Senses and feeling Another advantage of a sculpture is the complete involvement of all our senses and feelings. The impression we get of, and the persuasiveness inherent in, what we experience on a sensual level is more powerful than any cognitive conclusions we might make about relationship structures on the verbal level. The relationship structure helps us to visualize what is going on inside the system members. This is furthered when the participants are given some time to concentrate their perception within the sculpture. Sentences repeatedly spoken by the figures in the sculpture serve to increase the feelings of the participants. The sensual perception of the relationship patterns and the connection of this experience with emotions results in a holistic understanding of the processes going on in the system. Holistic, in this context, means feelings are present in addition to cognitive components.
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Using the body’s wisdom A further dimension of the sculpture is the somatic experience the actors have. If we direct their attention to their bodily perceptions by asking them to close their eyes and listening to their inner self, many report such sensations. Case example (this is taken from a family reconstruction in which the family members were played by other group members): Bettina’s family of origin consists of her father, her mother and herself. She puts herself and her mother close together. The mother touches her arm and looks her in the eye. Bettina looks at her father, who is sitting off at some distance in a chair looking out the window, with her back turned to both of them. Bettina had first dealt with her relationship with her father, who worked abroad a lot and was not often at home with the family. The sculpture showed that her father, presumably because of a trauma suffered during the war, was unable to be empathic toward his family, unable to show feelings and unable to receive them as well. Bettina’s mother was the main person in her life. The mother was disappointed in her marriage, but she took care of her daughter quite well. Bettina felt her mother dragged her into her conflicts with her father. She was also aware of her mother’s dreams working as a scientist, which she had given up in order to be a housewife. The counselor asks Bettina to start up a conversation with her mother. After a few tears her voice becomes steady and she berates her mother. The counselor asks her to feel what is going on in her body. She closes her eyes and after a short while says she feels a “lump in her throat.” The counselor asks her to put her hand on the spot and to feel what it is like. Bettina again has a feeling of a “lump in her throat” and connects the feeling with the anger she has toward the mother. It occurs to her that she is being treated for an enlarged thyroid gland. Later, in the debriefing, she talks about everyday situations where she feels anger but has difficulty expressing it, co-occurring with the feeling that occurs in her throat. Her somatic sensations and the interaction patterns fit together.
The counselor should try to discover and use such connections between physical sensations and interaction patterns: They intensify the clients’ process of increasing awareness. Social interaction patterns, emotional experiences and bodily sensations are mutually dependent. The counselor can also anchor them by touching the client lightly and pointing out the connection with the interaction pattern. This helps the client to later use the bodily sensation he remembers and recognizes in order to become aware of interaction patterns. The counselor can also use bodily awareness to establish alternative interaction patterns. Case example: Mr. M. (55 years old) and Mrs. M. (50 years old) have come to couples’ counseling because of mounting conflicts. Both children are out of the house. Mr. M. has been in early retirement for 6 months. His wife does not work. In the years leading up to his early retirement, they had simply learned to avoid each other, but now, with his being home all the time, the quarrels are increasing. Mrs. M. is considering moving out of their apartment. In a simultaneous sculpture intended to depict a typical situation leading up to a fight, the counselor notices that Mrs. M. holds her head down
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somewhat and doesn’t look directly at her husband, rather gazing at a spot slightly below his face. The counselor asks her to take a moment to concentrate on her posture and to notice the position she’s in. Mrs. M. realizes that she always avoids looking directly into her husband’s face. She says that, for a long time now, she hasn’t had to deal with him and his concerns. She’s afraid of giving in, doesn’t want to see him and she is worried that her anger might break through. Asked how sure she was of her feelings, she replies that she actually did want to continue to have contact to him. The counselor suggests that she raise her head a little, that she simply change by a few degrees the angle at which her vertebrae are holding her neck. Mrs. M. tries this small change out. She is now looking directly into her husband’s face. She reports that this changes the way she can relate to him considerably. Now she is seeing him as he really is and has the feeling of being his equal. She can face him and represent her own views more openly and more seriously. The counselor asks her to reverse the change and to reassume the original position with her head tilted down and to take note once again on the familiar pattern of interaction with her husband. The counselor leaves Mrs. M. in this position for a moment and then anchors her by touching her slightly, saying she should remember this position and what it feels like – and then go back to the new position. Again she concentrates on feeling what it is like, is anchored and fixes the moment in her mind.
Mrs. M. can now use the newly learned and anchored bodily position in everyday life. She can shift herself at will into the learned inner posture by virtue of a small change in her head position and gaze. This will hopefully enable her to better listen to her husband and rediscover his needs – as well as more clearly representing her own wishes toward him. The body’s bearing becomes a metaphor for inner bearing in one’s interaction with someone else. And it becomes an instrument to diagnose one’s inner status, to recognize it and change it even outside the walls of the counselor’s office. Disrupting patterns: Listening, not fighting Every participant is listened to while he is explaining his view of the relationships in a sculpture. That tenet alone serves to break up the existing pattern of interaction. When systems are in trouble, there is usually a rush to express the “right” description of the relationships. What then happens is clear: explanation, rebuttal, counterstatement, rebuttal – all in rapid succession. The nonverbal, creative and experimental nature of the sculpture lends itself to disrupting this pattern and creating a new, unfamiliar, productive space for listening to others and exchanging views on different experiences. Sculptures are effective not only due to the creative atmosphere they produce, but also because they represent a foreign, new medium. Disrupting patterns: In a gathering of victims circularity comes alive “I can’t be any different than I’ve always been. I’m forced to be that way because of the way other people act toward me. If they were to act differently, then I could, too. Actually, I’d prefer that and I’d be better off, for sure, but
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unfortunately . . .” Many clients describe themselves as victims – as only reacting and not acting. If they all belong to a single system, then we have a confederacy of victims, as it were. The “culprits,” it seems, are missing in action. A sculpture interrupts this attitude, which occurs particularly in the verbal descriptions of relationship patterns. The metaphoric depiction of relationships in the sculpture, on the other hand, allows a direct experience of the circular nature of relationships. The linear configuration of perpetratorvictim dissipates, and the reciprocity of positions becomes clear. Even if not everything is solved, everyone can learn something A further advantage of working with sculptures is that the participants of a sculpture usually have the subjective feeling of having learned something in the process – much in contrast to purely verbal sessions. Oftentimes, these discoveries surprises even the counselor and are not at all intended or even understandable from the context. But the metaphoric form allows such individual insights. It’s like looking at a painting: The intense focus causes every observer to develop an individual story that – to him – appears clear and true and is chalked up as a new piece of knowledge. That is what happens with sculptures, too. The advantage is obvious: Everyone has new experiences with the relationship structure of the system. And new information always means a chance at new behavior. Which relationship pattern should the sculpture depict? One need not always depict the entire relationship structure. Depending on the goal and the situation at hand we can work with partial contexts, subsystems, special questions and changes to the system. Relationships in subsystems: Often sculptures are employed to model the relationship structure of the entire system. But we can also focus on just one relationship, say, between two people in the system. Case example: In a family counseling session there is a problem in the way the parents deal with their children (two boys of 5 and 7 years). The oldest son has major problems with his social behavior and may even have to leave the regular school. During the session it becomes clear that the husband keeps providing his wife with new suggestions on how they can successfully rear the boys and be good parents. The wife, however, continually rejects all his suggestions. This pattern is repeated many times. The counselor decides to use this pattern as feedback for them by depicting it in an outside-in sculpture. He asks the husband to stand facing his wife, to look at her, to put one foot forward, extending his hand to her. The wife stands facing away from him, looking in another direction, her arms crossed in front of her, her shoulders slightly raised. Then the counselor asks the two to them to test whether this pose fits their own experience . . . Alternatively, he could have asked one of the two protagonists to create an inside-out sculpture of the last interactions of the session or allowed them to find the positions they deem typical for their relationship in the last session (simultaneous sculpture).
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Scalings as sculptures: Sculptures can easily be combined with scalings. In Chapter 5.3.1 we discuss this combination of sculpturing and questioning in more detail. Typical relationship patterns in the system: The object of a sculpture can also be a typical relationship pattern found in the system. Case example: A prompt for the sculptor in team counseling could be: “Please arrange your colleagues as you experience them. Of course, from time to time you will experience interactions in the team that are different. But for the time being let’s look at the typical situation. Please begin by putting everyone in his or her position in the room so that the distances and lines of sight are, in your opinion, fitting.”
Relationships changed by events: We would like to introduce some of the possible ways of implementing this technique and to show how to study the effects of sculptures. a) Before and after a special event: This form consists of two sculptures: one to depict the relationships before an event, the other after an event. Case example: An outpatient rehabilitation group of alcoholics at an addiction center meets weekly. The relationships within the group have now become the group’s central theme. For a couple of sessions there have been tensions within the group that have hindered some members from bringing up their problems and questions. During one session it becomes clear that a change in the group leadership due to the former group leader’s pregnancy leave has caused considerable changes in the relationships within the group. The (new) group leader suggests depicting these changes in a sculpture. She asks a particularly committed and well-accepted participant to set up her view of the group, particularly how she experiences the attitude of the individual group members toward the group, toward each other and toward the change in leadership. Then the sculptor is asked to prepare a second sculpture representing the time after the change in leadership. After a few minor changes everyone is basically in agreement about her two visions. The group leader now asks all group members to take up their position in the first sculpture; they remain in these positions for about a minute. Then the group leader asks them to slowly move to their respective positions in the second sculpture. This sequence is repeated a few times as a sort of pantomime, whereby the leader requests that everyone try to feel exactly what has changed in their respective role. They then discuss what they have experienced.
b) Appreciating the emotional quality of an event: The emotional consequences of an event can be studied by means of a sculpture. Sculptures make tangible even those feelings of which one was unaware while experiencing the situation, which were only barely felt and thus could not be consciously communicated to the system. The goal is to (retroactively) experience within the counseling situation what could not be experienced in the first place. This method tries to shape and organize both the present and the future without undue encumberment. Here a quote from Schweitzer and Weber (1982, p. 119): “It was impressive and moving for both the family and the counselor to experience how a young woman, the middle sister of 5, who at the age of 3 was sent to live with her aunt because of ‘lack of room,’ depicted her family at the time of her leaving; how she instructed
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them to slowly go hand in hand with the older sister who brought her to the aunt in the direction of the aunt’s apartment in the other corner of the therapy room. How painful this separation had been was apparent to everyone in the room through the hesitant nature of the process. This cleared the way for a dialog about the family’s situation at the time of the woman’s move.” c) Anticipating a future event: An upcoming event can be anticipated by building a sculpture. This allows the participants to adapt to the thought in advance. Especially with events that are accompanied by fears or misgivings, preparation by means of a sculpture can help reduce flight or avoidance behavior. Case example: During couples therapy, the counselor guesses that the husband’s retirement in a year’s time is causing some anxiety in both husband and wife. The husband is very engaged in his profession and spends many hours in his office. But the two have been talking very little about the situation, only joking about it from time to time. The counselor asks each of them to set up a sculpture, one after the other, depicting how their relationship will look a year after the husband’s retirement. Then they are asked to describe their impressions and feelings toward the other person’s sculpture.
Favorite sculpture: Here we are searching for solutions. The main questions are: What do the relationships have to look like so that the sculptor or the individuals in the sculpture are happy with it? What is the ideal distance between the different persons? Who must catch whose gaze? What gestures are appropriate? If necessary, this can be extended: What sentences could the individuals say to each other? This type of sculpture has the same goals as the questions we introduce in Chapter 5.3.2 (Problem and Resource Contexts: Using Circular Questions) and the Miracle Question. The counselor’s position in the system: A sculpture can even be used to highlight the position of the counselor in the system, if the system has brought this matter to the forefront on its own, or if the counselor has the feeling that there is some sort of problem with his relationships to the members of the system. Case example: In a family counseling setting major quarrels erupt between the 15-year-old son and his parents. This is why they have come to counseling. They have also brought along their 12-year-old daughter. The son expresses both verbally and nonverbally his feeling of being isolated in both the family and the counseling situation – that everyone is against him. The counselor requests that he portray his feelings in a sculpture and include the counselor in his depiction as well. The boy proceeds to place the counselor close to the family, lining them up in a row, not too far away, but still clearly as a front directed toward him. In a second sculpture, the counselor tries to clarify where he thinks the counselor should rather be placed so that counseling can be successful. This sculpture reveals that the boy wants the counselor to be closer to him than to his parents. He then describes what the counselor would have to say to correspond to this desired position: The son wants more distance and support from his parents. Next, the counselor and the son discuss what is realistic, what can be expected of the counselor and what is not possible or realistic. It turns out that the desires at least some more effort at “listening” on the part of the parents. He
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expects the counselor to create room for this. As for the practical side of living under one roof, especially the matters of household chores, curfews and monthly allowance, the boy needs some help (as do the parents) in determining normal modern guidelines. The counselor is willing to do that for them but does not want to become the son’s “lawyer.” In the end, the son is willing to accept this (though he would have preferred it differently).
5.1.2 Verbal Metaphors as Sculptures Up to now we have used sculptures to give emotions and hierarchical relationships a spatial form. Another way to represent the relationships in a system is to use verbal metaphors that are then turned into sculptures. The starting points for such a process can be as follows: – The counselor asks the clients to come up with a metaphor to describe their situation. – A verbal metaphor is taken spontaneously from the conversation. – The counselor suggests to the clients a particular scene. The counselor asks the clients to develop a verbal metaphor Peggy Papp sometimes asks the members of a system to come up with verbal images that describe how they experience the relationship. She then asks the clients to translate this picture into movements. The result is a sort of dance; she consequently calls the process “choreography.” Here is a case example of hers (1967, p. 353 f.) which nicely demonstrates her approach: Case example: A woman describes her husband as King Kong and herself as being trapped by his power over her. Her attempts to break out of this captivity, to attack him, to throw dishes at him, to fight with him and swear at him – they all lead to his grip getting ever more tighter. The husband also describes himself as a monkey – a helpless monkey. If the monkey wants to help her up off the ground, she rebukes him. If he tries to save her, she flees. The more he tries to help her, the more she tries to flee. The more she flees from him, the harder he tries to hold on to her. The therapist asks that the two attempt to depict these patterns by setting up a scene – but doing everything in slow motion. This sort of distortion toward the absurd gives them some room and clearly demonstrates to them the circular nature of their actions. Now the therapist asks that they try to choreograph possible solutions. Some very interesting ideas crop up. The may be truly helpful, but to a large part remain caught up in the usual patterns, which also says something about the couple’s coping strategies. The husband tries to establish his idea of looking eye-to-eye and on equal grounds by seating himself directly next to his wife. He thus relinquishes his King-Kong position, but still tries to save his wife by giving her good advice on how she can better organize her life. His wife rejects this outright and becomes angry with him. From the choreographed depiction of these interaction sequences the therapist discovers new tasks or rituals (see Chapter 5.10) that distorts their previous problematic behavior to the absurd and exaggerate it greatly (Papp, 1976, p. 352). Or the therapist directly suggests behavior complementary to previous behavior, for example, by suggesting they do exactly the opposite of what is normal – say, for a while the husband should give up his goal of wanting to save the wife.
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Every time he has the urge to give her some advice, he should instead ask her for advice. Although this seems absurd to him, he agrees. The therapist then asks the wife to do her part by writing down everything that occurs to her that she could do to tame King Kong. These actions shift the interaction of the couple and skew their mutually applied roles. Now the wife advises her husband, while also showing him that she trusts that he will make the proper decision. This, in turn, influences the husband to change his rescue-and-counsel behavior over time.
In this example we can see how intensively Peggy Papp uses the pictures that develop in the course of couples therapy to work with the couple concretely through variations on the theme of “strong man saves helpless wife.” The important thing is to use the language, metaphors and images from the clients’ own world since their familiarity creates understanding and acceptance. By graphically imagining these pictures and by turning their problematic behavior into a choreography the couple can learn to recognize their own role in the unfolding drama that has landed them in therapy. And after going through this process, it becomes harder to simply repeat these patterns without thinking of the scene they created; the exaggeration increases the exercise’s effectiveness. From the pictures and metaphors the clients have generated they can also derive new ideas for the tasks. Any resulting progress and successes can then be translated choreographically in the next session, thus leading to new patterns. A verbal metaphor is spontaneously adapted Clients often employ metaphors in their normal everyday language. Such images express, sometimes rather precisely in fact, their way of experiencing things, making it worthwhile to work on such visions. Case example: A family comes to counseling because the mother (45 years old) has repeatedly been plagued by psychosomatic states of complete exhaustion. Her two children, Susanne (12 years old) and Paul (14 years old), are very burdened by the whole situation. They fight over what time they have to go to bed, who does which chores in the household, etc. The father has, for the most part, withdrawn from family life. There is considerable tension between the husband and his wife. Tending to the household, raising the kids and earning a living have led to much bickering, mutual accusations and withdrawal. In the following sequence, taken from the family’s third session, the family is talking about the turmoil and stress in the family caused by visitors and the telephone constantly ringing. The father expresses his dissatisfaction and says that sometimes he feels like he’s living in a “castle under siege.” The counselor picks up on this image and asks him to depict the castle in the room, to which he agrees after some persuasion. He puts himself in the middle, surrounded by a close ring of chairs: a lord taking refuge in his tower. He has to fend off the attacks of his wife and children from the outside. Only his son can pass the barriers. And yet he doesn’t really feel like he’s lord of the castle: The other inhabitants are besieging his castle, and he’s stuck in his tower, his final refuge, which has to be defended against the invaders from outside and the other inhabitants. But the castle’s walls are weak. He assigns the children the task of being gatekeepers. They, however, more or less let anyone pass, even those besieging the castle, rather than seeing to it that they are kept out. The wife is appointed administrator of the castle who runs back and forth in the castle courtyard rather confusedly, wailing loudly. The family members agree that
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this image mirrors a number of aspects of their family life. Asked individually, they each have their reasons for acting the way they do in the father’s scenario. The father says he needs his peace and quiet. If he were to come down from the tower and try to create order, his children would fight back and his wife would intervene. He feels isolated from the castle’s other inhabitants and is happy to be out in the forest during the day. The children say that they are happy they have contacts on the outside since it’s hard to tolerate castle life: a disgruntled lord, a bossy and nervous administrator. Otherwise, though, its OK in the castle. They have free reign for the most part. The administrator feels helpless, abandoned by her lord and constantly angry at him. She’s the administrator, to be sure, but no one listens to her: The inhabitants just do whatever they want. She doesn’t like entering the tower. She’s afraid of the quarrels that inevitably ensue with the lord. She feels torn between the two worlds and lives without any goals, full of sadness and resignation. The counselor asks the lord and his administrator to “reorganize” castle life. As a sort of game, they begin to regroup the chairs, establishing – first and foremost – a stronger external wall. They decide to set up times at which the gate should be completely closed. From 7 to 8 pm as well as from 9.30 pm to 7 am the castle is closed to outsiders; no visitors and no calls are allowed. The gatekeepers protest against the new rules, and the following conversation is devoted to how the administrator and castle lord can assert their wishes toward the personnel.
The metaphor and the depiction of this scene provide everyone with a new look at some old patterns. Shifting the context (from family life to castle life) distorts things enough that the existing patterns become visible and can be worked on – and solutions sought – in a game-like, creative way. Of course, no solution will be implemented without modification; rather, it is important that the patterns be recognized and lead to new solutions. The counselor suggests to the clients a particular scene and lets them stage it psychodramatically Here, the counselor provides the entire framework for a scene and invites the clients to use it to stage their relationships. Case example: The following scene is taken from the first session of a family consisting of the father, the mother and two daughters, Clara (8 years old) and Lisa (4 years old). They have come to counseling because of Clara’s persistent soiling of her pants (encopresis) for which doctors have no medical explanation. Also, the parents want to talk about their own relationship, since it has been strained recently with respect to raising their children. After agreeing with the family on a contract, the counselor suggests playing a game together and asks Clara to imagine the family as animals stage it psychodramatically and what animals she thinks they would all be. (This method is taken from the projective test “Family as Animals,” Brem-Gräser, 2011.) She is to put the different animals in their place as she imagines them. The result is the scene shown in Figure 26, whereby the arrows depict the lines of sight.
Figure 26: Family sculpture with animals
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The counselor then interviews each family member and asks how they feel about their position. Clara finds her position very tiring because she can’t move her head. She always has to look toward the “elephant” and sees the “monkey” and the “cat” out of the corner of her eye. She doesn’t like that at all. The mother, too, thinks her position is rather uncomfortable because she always has to look up to the “elephant” – and she can’t see the “monkey” at all. She misses seeing the “monkey.” But she likes being a cat. The father feels too far removed from everyone. It bothers him that he can’t see the “cat.” And he feels too insecure standing on just one foot all the time. Lisa, however, is very happy being an elephant: Everyone is looking at her. She would also like to set up an animal scene. The parents have their own ideas of how the family should be and depict their own scenarios. Then it’s Lisa’s turn, and she drafts the sculpture shown in Figure 27.
Figure 27: Lisa’s family sculpture with animals
Clara is the first to speak and says she doesn’t like this picture at all. The mouse should come down from the chair. The counselor suggests they all play a game together, and the family agrees. The “zebra” tries to talk the “mouse” down from the chair, but the “mouse” refuses to do so. She’s the “queen mouse” and that’s her throne! The “rooster” and the “pig” also try to persuade and entice the mouse to come down. After a while the “zebra” seems rather helpless. The counselor says to the “zebra” it would appear that the “mouse” is not going to come down from the chair on her own. The “zebra” then goes over to the “mouse” and tries to push her off with its nose. The “zebra” and the “mouse” jostle for a while, but then the “zebra” just stays put on the chair next to the “mouse” and says she likes it there and wants to stay. The “rooster” and the “pig” are ok with this solution. The “mouse,” however, is not so happy. There’s only time for a short discussion. Clara says it was fun what they did, especially the fight with Lisa as “mouse,” and that she could sit next to her. Lisa thought it was fun, too, though she did not enjoy the ending. A discussion ensues between the adults while the children play on the floor. The parents are very moved by the experience of seeing how helpless and weak their older daughter is and how strong and dominant their younger daughter is. It has become clear to them just how difficult Clara’s position in the family is. Clara’s open fight with her sister was something new and unusual for them to see. The first scene, in which Clara stood between the two of them and tried to keep a watch over everything, brings to their mind a number of similar situations from past family life. Clara has always assumed a lot of responsibility for what happens in the family, especially in situations in which the family disagrees about something. It is also true that Lisa receives much more attention. The parents both come to the conclusion that they should see to it that there is more of a balance between the siblings, and that they aren’t wooed by the
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youngest daughter’s charms. They intend to work on how to better shape their roles as parents.
This method is especially good if there are younger children present in the session. This way, parents can see how their children view the situation, and the children get the chance to participate – without having to explain themselves verbally. Their natural way of expressing what they experience and how they work through it correspond to the symbolic representation and game-like atmosphere of this method. In the case history above, Clara suggested a solution: She wants to sit next to her younger sister and is ready to fight for that position. The intensity with which clients experience such games allows the most important patterns to be dealt with in the conversations that ensue.
5.1.3 Sculpture as a Metaphor for Time: Memory Lane2 How a system develops can be shown in a series of distinctive events (milestones, stumbling blocks, turning points, etc.). In families, for instance, these might be marriage, the first child, moving into a new house, the birth of a second child, the mother’s going back to work, the mother’s professional advancement, death of the father’s parents, bouts of depression in the father. In an organization, these could be the founding of the company, the first generation of employees, the coming and going of employees, changes in the financial situation, market changes, new managers, the takeover of another company, reorganization, etc. Such developments within a system can be drawn up with the help of a line on the floor (thread, chalk, tape) representing time, along which the important moments in the development of the system are added from the participants’ memory. A kind of “memory lane” is formed between the founding and the present day. The events can be depicted as follows: – The effects of the major events on the relationships in the system are depicted by sculptures. Present system members take up their positions; former members are represented by symbols. – The events themselves are represented along the timeline by a symbol and a year. This complements the method discussed above. – With little figures like those found in most children’s rooms we can depict all types of events along the timeline. This type of “sculpting” can be used to portray an entire system (a family, a couple, a team in supervision, an entire organization), whether in counseling, in supervision or in personal coaching. 2 This designation was coined by Antony Williams, who used the technique from his book “The Passionate Technique” (1989) in couples therapy. Later he also used this form for working with whole organizations. He demonstrated the method in the summer of 2002 in a seminar in Heppenheim, Germany.
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The participants then walk along the timeline and do some configuring. They look back from the present point in time over the entire history, they gather impressions and suggest new ideas. The interconnections between present and past within the system are discussed and the consequences spelled out. One can also venture a look at the future: – What will happen in the future? What is foreseeable and within what timeframe? – What are our goals? How do we want to shape probable events in the future? The timeline can also be extended beyond the present. Antony Williams3 suggests retracing the steps with the sculptor at the end of the allotted time and revising the stations with the knowledge won during the discussion. This cements one’s personal connections to the development and to the course of time. The possible ways of interpreting past decisions become clearer. Case example: A team within a large organization has the job of organizing advanced training seminars, advising managers, accompanying structural developments and supporting new trainees. The problem is that its collective identity has been lost over time: Now everyone just does their job. The work itself is carried inconsistently, which outsiders have begun to notice. This poses a danger to the very existence of the team. A uniform style and a uniform political stance have not been effective because of the lack of a common identity. The counselor suggests an “identity-fostering” intervention in the form of an in-depth look at the team’s past and present. To avoid long discussions and intellectual debates, this is to be done as a timeline drawn in the counseling room. The counselor asks the team to pick out a point in the room to designate as the founding state and another for the present state of the team. The counselor takes up position at the founding point – together with the only team member who experienced the beginning personally, who describes what was going on back then. Earlier team members, the head manager at that time and the head of the personnel department are represented by symbols and put on the right-hand side of the line in a little sculpture of their own. Each one of these figures from the past is assigned a phrase that begins with: “This team is important because . . .” and is completed by something befitting that figure. The enthusiasm of the team’s pioneers can be felt in their sayings: “This team is important because everyone depends on it to make the company fit for the future.” At the managerial level, one hears very different statements: “This team is important because the department heads, the team leaders and some employees can finally get their way and stop whining about how they’re so stressed by having to suffer through quality management, reorganization, personnel problems, etc.” “This team is important because I can send anyone to take part in it who’s bellyaching and complaining about conflicts.” Bit by bit, new employees are added to the team along the timeline. They join the counselor and are put on the side of those team members already present on the left side of the timeline. When the pioneer members leave the group, they are depicted by symbols at the respective points in time on the right side of the timeline. Upon leaving, they are assigned a typical phrase by those team members who remain standing to the left of the rope. Many 3 The author (A. F.) visited several seminars of Antony Williams between 1998 and 2005 and gained many insights and impulses concerning this work method.
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of the pioneers left the team because they were unable to realize their ideas. They leave behind sayings such as, “There used to be more drive here. Today, there’s only roadblocks.” “I need new possibilities. Nothing’s happening here anymore.” Sculptures are set up at certain timepoints along the way. The founding team had great solidarity and was very self-confident. The “new guys” failed to be integrated into this “old guys” team, resulting in two groups. The tasks the groups worked on became ever more mundane: organizing individual coachings, team-development seminars, counseling for personnel problems. The tasks used to be concerned with the organization and moderation of quality circles or control groups for reorganization processes. Nevertheless, the team retained its original spirit of being a spearhead for innovation and renewal. The new members dealt with this issue by drifting toward ever more individualization – which is clearly depicted in the sculptures. Upon arriving at the point marked “now,” one is confronted by an almost entirely new team. Although the team’s former images for the in- and out-group still exist, the present team no longer identifies with them. The counselor asks the team to take a few steps into the future, beginning at the point marked “now,” and to brainstorm on the following questions: – What will the future bring and what will be expected of us? – What must happen in order for us to fit into such a future? The cards with future events and demands are spread out across the section marked “future.” Now the counselor and the team go backward in time along the timeline. At each station the respective changes are noted. Present team members wander along the points in time at which they entered the picture, from left to right. Team members who had left the team come from right to left. Finally, the team is asked to use whatever they find in the room to create a sculpture that depicts how the team must look in one year’s time if it is to survive.
This example demonstrates how to develop one’s own creative style. Memory lanes can be set up in many different ways. Here are a few pragmatic tips: – Deciding where the beginning and where the end of the timeline is should be left to the clients, who are better in the position to lay down the timeline for the developmental history. – The present tense should always be used at the various stations along the timeline. That reinforces the feeling of reliving the events. – One can also mark the point in time with a piece of paper with the respective year and a keyword to describe the particular event. That makes it easier to keep track of the stations of memory lane.
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5.2 Extensions: Sculptures in Different Settings The previous chapter clearly demonstrated the many ways sculptures can be employed in systemic counseling. The inherent creative potential present in this method begs for the development of ever more variations for use in diverse settings. We would like to introduce a few in the following sections.
5.2.1 In Individual Therapy: Social Atom and Chair Sculptures Sculptures can be used when working with individual clients to point out the client’s system and the context of the problem. The “social atom” method depicts the client’s entire relationship network. The term was coined by J. L. Moreno (2008), who felt early on that human beings mustn’t be viewed without also considering their respective context. Within the “social atom” he places the individual at the middle, at the core or nucleus of things. Social relationships differ in their intensity. The most intense ones are the electrons that circle the core in very close orbits, whereas less intense relationships are the electrons in the midlevel orbits, and more distant relationships are similar to electrons in the farthest orbits (see Chapter 5.7 below). One can visualize and symbolize such a social atom with very different means: – imaginative figures (animals, cowboys and Indians, knights, peasants, Disney figures, Smurfs, dinosaurs, monsters, aliens), – natural materials (rocks, crystals, shells, marbles, twigs, chestnuts, acorns), – stylized abstract wooden human figures without specific characteristics. Depending on one’s own preferences, one can have various sets that also correspond to a client’s various preferences. Young girls, for example, often react positively to exquisite natural materials in a pretty box laid out with a silk cloth. This method is particularly helpful when working with individual children or adolescents, who are not necessarily used to or amenable to a verbal approach and may feel uncomfortable in a direct one-on-one situation with an adult. To ease the tension, place some sort of material object between counselor and client to symbolize the playful nature of the interaction – something both sides can look at and enjoy (and thus avoid always looking at each other). This is especially useful for the in-between ages, where a children’s game is no longer appealing and adult conversation is not yet appropriate. The “social atom” provides an overview of the client’s social network with all its resources and relationships. It can also outline what positions the individual members of the social environment hold with regard to the client’s most important questions: How should the client live? How should the client decide a vital matter? What do the other people in the social sphere think about what should change through counseling? What do others think the core problem is? What could be the solution? Who can change things?
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Case example: Catherine (16 years old) lives in a residential group where she is cared for by social workers around the clock. For the past 3 months she has had a boyfriend (John), who is 17. A couple of days ago she discovered she is pregnant with his child and now has to decide whether or not to have the child. The caretakers, the other girls in her group, her best girlfriend, the whole clique, her boyfriend’s clique, too, and a few members of her family are aware of the situation. Her teachers, her father (separated from her mother) and a few other adults, however, know nothing of her dilemma. She talks to a number of those in the know. These conversations often proceed according to a certain pattern: “What do you think I should do?” The other person answers and she reacts: “Yeah, that’s true, but for me on the other hand . . .” Finally, she sighs a heavy sigh and laments: “Now I know even less what I should do!” Catherine and her main caretaker want to work on this matter, and Catherine is very interested in what her caretaker has to say. The caretaker suggests her setting up a social atom with toy figures to represent all those people who presently play an important role in her life. Then, later, she’ll say what she thinks. Catherine agrees to this plan. Catherine looks at the figures and decides which ones should symbolize which persons. For herself, she chooses a very pretty white stone. The caretaker lays a sheet from the flipchart on the table and asks Catherine to put her white stone in the middle. She is now requested to position the other figures around her, at varying distance, depending on the intensity of their relationship to her. Persons who belong together form a group, which helps one to recognize which groups are important to her. The caretaker writes the names of the persons next to their figures. Once Catherine has set up all the figures in her sculpture, the caretaker asks her whether there are any other people who have had an influence on her other than those in her network. Those could be idols, persons she has met, her late grandmother, a former teacher, Mother Mary – whatever. After the sculpture has been completed, the caretaker asks Catherine whether she is pleased with the image or whether she would like to change anything. After a few minor corrections the image is complete (Figure 28). Now the caretaker asks Catherine whose opinion she counts on, out of all those represented in her sculpture. She chooses her late grandmother, so the caretaker asks the grandmother: “Mrs. Thomson, you have been dead for a few years now. You are surely looking down from above at what’s been happening in your family. So you also know that Catherine has been having a hard time making a decision. What do you think Catherine should do?” Catherine answers as her grandmother in the first person: “Yes, yes, I’m very sorry about that. The child is still so young, much too young to have a child of her own. It will ruin her whole life if she gives birth to a child! And it can’t be good for the child either!” “Why would you think that? Was that your experience in life?” Again, Catherine answers as Grandma Thomson: “Yes, I’ve told Catherine many times that she should be careful. I told her how awful it was for me, when I had my first son at the age of 19. His father left us even before the child was born, and the child eventually ended up in an orphanage at 6 months. I just couldn’t take care of him, and later, when I did see him, I felt so sorry for him. That was the biggest mistake of my life!” The next person Catherine is interested in is John, her boyfriend. The caretaker interviews him just like the grandmother, and Catherine touches John’s figure and answers for him in the first person. And so it goes on, one figure after another. At the end of the session, the caretaker asks Catherine to put the figures on a scale between the two points denoting “definitely have the child” and “absolutely don’t have the child.” Catherine arranges her whole social network along this scale. She includes the caretaker, too, or at least what she
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Figure 28: Symbol sculpture of Catherine’s social atom
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presumes the caretaker’s opinion to be. Catherine also puts her own white stone on the scale at the point that reflects her present tendency.
In this case example, the “social atom” of the client was complemented by important people from her past. In Chapter 5.5 we go into more detail on working with “witnesses.” In the end, the “social atom” helped to sort out the opinions that existed in the client’s life. The example illustrates how dealing with different positions in the social network forms the basis for making decisions on one’s own. What do these important people in my life think about my problem and why do they see things that way? Which of all these opinions are most important to the client? What does the entire spectrum of opinions look like on such a continuum? And where on the scale does the client place herself? For the caretaker/counselor this method has the advantage of preventing his or her own opinion from standing alone and taking on too much weight, since many other opinions have bubbled up through the “cosmos of perspectives and viewpoints” induced by working with the social atom. The plurality of perspectives to be considered provides the client with a special form of freedom toward the opinion of the helper. Here are some of the effective methods employed by the caretaker toward Catherine: – Putting the flipchart sheet down and writing the names of the persons portrayed by the figures is a great help. – Touching the figures whose role is being discussed supports the representation of the respective role, as does the use of the first person when answering. This allows for an intense, realistic change of perspective. – The helper provides a clear structure and plays the role of interviewer to give the client a sense of security and to help the client stay within the given structure.
5.2.2 The Family Board4 The Family Board was originally designed for use in the diagnosis and portrayal of family relationships (e.g., in matters of custody), but was soon adapted for use in the presentation and development of supportive family relationships and inner dialogs. It is also used to describe desired future scenarios in extended family systems (see Ludewig & Wilken, 2000). The Family Board is a 50 × 50 cm board containing square and round figures (male and female) in various sizes (parents and children). Three extra figures (white, brown and black) do not represent persons, but rather features, intentions and so forth. Once the goal of the session has been mutually agreed upon, the Family Board is introduced in order to work on a solution. Similar to the way it is done with sculptures, the figures are set up to represent real persons in real-life networks, using the criteria closeness/dis4 These remarks on the family board stem from our colleague Hans-Werner EggemannDann (see Egemann-Dann, 2004, 2005, too), who wrote them as part of our course materials, which we modified and extended for this book.
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tance, like/dislike. The resulting images are used to develop hypotheses, to discuss impressions with the clients directly and to try out solutions in this three-dimensional space. Using the Family Board slows the pace, tempers aggression, adds a playful note to the session and directs the client’s attention to another level of communication and symbolization. It’s a little like staging a puppet theater performance. It is suitable for children of school age and older, since younger children tend to knock the figures off the board. One can put little notes on the individual figures with keywords concerning problems or solutions. The use of finger puppets and other accessories allows further symbolization. The Family Board, like other forms of sculpturing, can be employed in many different ways when working with families, individuals, couples and groups, whether in counseling, therapy, coaching or supervision: – Individual clients can depict their original family, their present constellation or situations that crop up at various times in therapy. – Partners in couples therapy can demonstrate how they see things and comment on the other person’s portrayal – or what they presume the other person is trying to say. – Changes and future scenarios can be anticipated. – Children can sketch their way of seeing things and develop change scenarios. – One can catalog resources in the client’s context and experiment with their implementation. – Constructions can be given various names, borrowed, for example, from films, novels, newspaper articles or songs – whatever creates distance and can be played out on a symbolic-playful level. – A family member can work with the board while the other members comment on the result, in the sense of a reflecting team. – One can use two boards simultaneously to compare two scenarios. Case example: After being introduced to the method, a young female client depicts her (extended) family with the figures. On this basis we ask about her resources: – Concerning her mother and father: “What are the positive sides to the relationship? What did they pass along to you? How has it helped you? What and whom can you depend on?” – Concerning her siblings: “What do you like to do together? What are your survival rules? What are your differences and similarities and how do you deal with them?” Then we ask about the client’s desire for change, which is given a physical form using the board: “In which areas would you like for things to change? How can that be done? When you’ve finally reached that point, where would the figures be and what would the scene look like? How much of this change has already been realized? How would you notice that progress is being made? What do you expect from others? Are they aware of your wishes? What is your part in making it all come true?” One could also focus on the themes of patience and perseverance, dealing with defeat and other ways of receiving support. One can take a picture of the scene with a camera
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and look at it later. One can note resources on different colored cards and use Post-its to write the traits of family members on the blocks.
Clearly, the Family Board can be used in a number of ways similar to the “social atom,” the most important difference being the materials. If the counselor wants to introduce elements of family reconstruction into individual therapy, then the Family Board can also be used as a methodological tool when searching for clues and memories (Neumann, 2004): The client stages past events, and one then uses the symbolizations to work through ensuing questions.
5.2.3 Symbol Sculptures Since its inception, the materials and formal aspects of the Family Board have been well described and its use has been standardized (Ludewig & Wilken, 2000). As with the “social atom,” one can use other objects, such as coins, stones, cups, building blocks, animal figures, paperclips, notepads or any other object that happens to be lying around instead of human figurines. Symbol sculptures can be spontaneously set up by the counselor, too, to sketch out a particular situation. Case example: The counselor uses the cups and glasses sitting on the table during a session with managers to demonstrate a difficult relationship between an employee and two managers. She asks the participants to use the objects to show her how the structure could be improved. In the end, the group transfers what is learned to everyday life by agreeing on how communication can be better structured in the future.
Symbols are more likely to lead to projections and magical-playful interpretations than any neutral wooden figures would (Schmitt, 2004), and the effect can be increased if the counselor presents well-prepared materials. Here are two examples: – Animal figures: Especially when working with children one can use little plastic or wooden animal figures instead of wooden figures. This method is derived from the projective test “Family as Animals” or “Magical Family” (Brem-Gräser, 2011; Kos & Biermann, 2002). In sculptures, a third dimension is added, which brings with it the advantage that one can try out a series of different assemblies. The family session described in Chapter 5.1.2 above, which included a family sculpture based on “Family of Animals,” is a more physical form of the same procedure. – Finger puppets:5 Finger puppets can be put on corks, with little magnets attached, and placed on a metal board. The puppets can represent most anything – princes, queens, witches, knights, ghosts, villains, animals, etc. This not only awakens childlike imagination in all of us, but also brings out whatever we pos5 Our thanks to Inge Liebel-Fryszer for this idea. These materials are well suited for both children and managers.
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sess in terms of creativity, curiosity and humor and can lead to some very good solutions. Working with such methods follows a similar pattern to working with sculptures: – Determine the mandate, set the theme, get permission to use symbolic materials. – Set up the system, describing it from the vantage point of the individual members. – Let the image sink in, query participants about their impressions and feelings, make corrections if necessary. – As in a fly-over inspection, take up different viewing positions, verbalize the views of those involved (similar to walking around and through a sculpture). – Sound out any changes and ask: What changes can be made? What do the new images look like? Which reactions and evaluations are to be expected? – Transfer to reality: What does this all mean for the future? How can we take the first step toward implementing these insights? Merl and Korosa (1981) describe so-called chair sculptures that can also help to depict relationships in a system. This form of sculpturing is useful especially when working with individuals. Chairs can represent social systems that are not present at that moment. The distance between the chairs corresponds to the emotional nearness or distance between the members of a system, while the position (front/back) indicates the line of sight. Once the sculpture has been finished, the counselor and the client can try out taking a seat on the various chairs. This lets them feel the effect of that position and perspective (Merl & Korosa, 1981, pp. 147 f.).
5.2.4 Working with Sculptures in Case Reviews Case reviews are held in teams, workgroups, supervision or training groups in order to take a closer look at relationship patterns. The members of such a group assume the roles found in the system, and the counselor introducing the case describes the system from his or her point of view. The various perspectives within the system are then experienced and felt by all. During this process, system patterns can be both “seen” and relived through the observation of the actors and their feedback. This helps to understand the needs and standpoints of the individual system members. One also gets a feeling for whether the version proffered by the responsible counselor is indeed plausible or not: Does the group as a whole experience the presented vision of the system as something coherent and consistent? Case example: In a youth welfare institution with both inpatient and outpatient facilities, one problem that regularly crops is that an exploration is carried out by someone from the inpatient section who later becomes responsible for the child and the child’s family. This
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person is then in possession of a lot of information and can easily create hypotheses about how counseling should continue. The other colleagues in the group, however, tend to have less – and sometimes other – information and have difficulty promoting their own hypotheses. The same problem of coordinating information and hypotheses in a particular case occurs when a case is handed over from one section to another, for example, when youths are moved from the emergency ward6 to an external residential group, or when Social Services take over a case from an external residential group. Many questions arise in such situations: How can one best pass on information about the client system? How can those giving and those receiving such information best exchange their working hypotheses concerning the respective case? The solution lies in creating a ritualized moderation of such sessions, during which the current colleagues present a sculpture, assuming the roles of the family members, the helpers and institutions involved. The counselor who conducted the exploration or who is passing the case on goes first in setting up a sculpture. He stands behind each figure in turn and describes his take on how the respective person was involved in the problem, what solutions were suggested, and what the institution can do to help. Everyone present can step out of the assigned role and add to what has been said about that figure. Later, one should plan for time to ask any questions the participants may have about the figures in the sculpture. Anyone with a suggestion of what that figure (or institution) might answer can come out of the sculpture, stand behind the figure and answer the question correspondingly. Thus, the participants often have two roles in this phase of the discussion: that of the helping employee and that of a figure in the sculpture. Once those present feel they have gotten to know enough about the system, the sculpture is declared finished. In the next phase, the hypotheses are compiled, and the group decides what emphasis to place, which topics to focus on and, of course, who will do what.
Of course, the various forms of symbol sculptures described above and the Family Board can also be used in case reviews or when forwarding cases to new teams.
5.2.5 Sculptures in Family Reconstructions In family reconstructions, sculptures can often serve as starting points for – recognizing relationship patterns in the original family, – experiencing the solidarity present in earlier systems, – discovering what roles the other family members were forced to play. Besides the protagonist’s family of origin (and sometimes the present family) one can depict the parents’ families of origin as well, which creates understanding for the patterns the parents have “imported” from their respective families. This, in turn, allows one to view relationships as far back as three or even four generations – which can be a source of deep insight. Such reconstructions also allow the 6 The emergency group admits children and adolescents from acute situations. Such actions, often initiated by Youth Services or the police, can take place at any time of the day.
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protagonists to change relationships in existing contexts and to gain clarity or find reconciliation with respect to the families of origin. Our childhood experiences and interpretations form the basis of family constructions that include our father and mother. By reconstructing important scenes from the family of origin in the form of sculptures we rejuvenate, as it were, old experiences. When we swap roles with other persons in our family, when others provide feedback on the sculpture, and when the reconstruction provides insight into the relationship patterns of our parents’ original families, we have the chance to expand the childhood points of view considerably. What we failed to see as a child can now be re-seen and experienced more completely in the expanded reality of the reconstructed families. Reconstructing the contexts of one’s parents and grandparents allows us to encounter and understand the interaction of the forces active in the original family as well as the natural limits of the parents. This makes possible new interpretations, deconstructions of previous viewpoints and new approaches to one’s original family. Feeling, understanding and accepting past disappointments, unfulfilled expectations and deep-seated rage permits old relationships to be resolved. This leads to changes in one’s attitude toward one’s own parents, but also injects new elements into the relationships toward one’s present partner, children or colleagues. Case example: Paula wants to work on her relationship to her 8-year-old daughter by participating in a family reconstruction within a training group. She has the feeling that much is positive about their relationship, but that some things such as a smooth transition from closeness to autonomy just don’t work: She has difficulty letting go and allowing her daughter to find her own way. Paula sets up a sculpture of her family of origin with other participants from the group. Her father and her older sister stand about 2 meters (6 ½ feet) apart, the father looking toward the older sister, who then takes a step away from the family and says to Paula: “See, it works!” Paula’s mother and Paula are standing about 4 m (13 ft) apart from each other, the mother is holding Paula in her arm and saying: “You’re just like me!” The mother looks at Paula, Paula looks at her father and then takes a step away from the family and says: “I’ve gotta get out of here!” The person playing Paula in the sculpture has the impulse to walk out of the sculpture. Now Paula takes over the role of her mother and feels sad and lonely, she starts to cry. She just can’t let go of the daughter. In the role of the mother, she is unable to take Paula into her arms, but cannot let go of her, either: She has so little in life to comfort her. Paula, as the mother, wants to be held and supported herself. A member of the group gets behind Paula, braces her up and holds her in her arm. Paula feels that only by being held herself can her mother provide the necessary support for her daughter and let go. Asked whether the mother had that support in her marriage or her family of origin, Paula answers no. The mother received little attention and comfort from her own mother (Paula’s grandmother). The group leader now asks Paula to enact the relationship of the mother to her own parents (Paula’s grandparents) for the time when she was a child herself. Paula puts the grandfather on a chair. The grandmother stands in front of the chair and looks up to him with great reverence. Paula assumes the position of the grandmother for a while and experiences how the grandmother is fixated on her husband and how she is unable to even turn
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toward their daughter (Paula’s mother). The grandfather provides a footing in life, the protection and security that the grandmother did not enjoy as a child, her own mother having died during the birth of her younger brother. The father’s new wife demanded from him that the children be sent to another family, and so Paula’s grandmother left her father’s home at age 5, shortly after the death of her mother, not to return until 6 years later. The new family did not show much love and had apparently taken on the children primarily because of the money involved. Later, the relationship with the stepmother, too, became strained. Paula’s grandmother gained a sense of security only through her relationship with her husband. She felt insecure toward her children and could provide them with little stability. After this reconstruction Paula says that stepping into the roles as she did had allowed her to experience intensely how well the pattern of insufficient attention had been passed on from one generation to another, from mother to daughter. At the same time, she had felt that things could, in fact, be different, and that she had the desire not to pass on this pattern to her own daughter. It isn’t easy for her to be near her own daughter, but she still wants it to try it. Her goal is to give her daughter closeness – including physical closeness – as well as autonomy and to see to it that she as mother still has a life.
Background Text: Systemics and History From a systemic perspective, existing relationship patterns are often used to explain behavior. One first asks whether what is happening right now in the family makes sense when seen from within the system interactions: How do the behaviors in the system stabilize each other, how do they interact with each other, how do they affect the system’s problem? In systemic therapy, the problem is understood from within the context – not from within the personality of one or more system members. In systemics, one is usually concerned with the present and future. The past plays less of a role, but does occur as part of the developmental process of a system. In the above discussion on timelines and memory lanes – and on taking a family history, problem history and history of previous solutions – we saw that problems can be contextualized through the history of the system. The background of a system today may be found in how it developed. In family reconstructions, we deal with a pattern of explanation that presumes that the context for problems lies in the past of the individuals involved. Certain behaviors and experiences used to be meaningful and important in the system, and within that context they were seen by the individuals as solutions. In a family reconstruction it is often assumed that the father and mother learned certain patterns of shaping relationships and communication in their own families of origin, and that these internalized patterns are influencing events today. We may also arrive at this assumption when trying to explain the behavior of children in a children’s home or at school. This sort of explanation is very tempting and often helpful. Strictly speaking, this is how one effects a decontextualization and an individualization of the problem. The assump-
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tion, however, presumes that at some point in the past there was a context in which the behavior would have made sense. This behavior, so one assumes, has now become grounded in the individual as a pattern. Another common way of explaining things in a reconstruction is to presume that our images were constructions of our families of origin from the perspective of children – and thus suffer from the very limited processing capacity of a child’s brain. These images are additionally colored by the perspective of the observer, who has a certain role and position within the familial relationship structure. Attempting family reconstruction in a group, and thus having the group correct childlike perceptions from an adult perspective, allows one to readjust old family “portraits.” This can make them more functional and – one should hope – wiser. In this regard, too, we trust that deconstruction and subsequent reconstruction will expand our behavioral range in the here and now.
5.2.6 Systemic Structural Constellations As with the Family Board or sculptures, figures can also represent abstract aspects and not just persons: goals, tasks, diseases, feelings, decision options, the inner team (various opinions in inner conflicts), views on a particular matter, inner voices, etc. The grandmother’s anxiety can be given a physical form, alcoholism can be depicted by a bottle, the “stinky monster” (from encopresis problems, see below Chapter 5.8) can be visualized with a puppet, internal drives and convictions (“Give it your all,” “Don’t show weakness,” “Business before pleasure”) can be symbolized. These extensions of the sculpture concept were developed early on by Matthias Varga von Kibéd and Insa Sparrer (2011), who combined the various methods into the concept of “systemic structural constellations” and then went on to develop their ideas against a new theoretical and methodological background. Their work goes back to four origins: the reconstruction and sculpture work of Virginia Satir, the hypnotherapy of Erik Erickson, the various previous family constellations (of Thea Schönfelder, Ruth McClendon, Les Kadis, Ivan Boszormenyi-Nagy and Bert Hellinger) as well as the solution-oriented methods and positions of Steve de Shazer and Insoo Kim Berg. These structural constellations were consciously conceived as systemicconstructivistic procedures: The group leaders generally refrain from providing interpretations, provocations or prognoses. The following are a few examples of how this is implemented: – Making decisions: Setting up the various options in the room, according to the criterion of how conceivable they actually are for the client. If necessary, the protagonist can provide the individual options with phrases. The protagonist then wanders around within the set-up, looking for a good place to situate himself, sometimes even debating with the options.
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– Tetralemma work (acc. to Varga von Kibéd & Sparrer, 2011): When the client has to choose between two alternatives, four different positions are set up in the room (symbolizing the possibility of choosing “the one,” “the other,” “both” or “neither”). The protagonist goes from position to position and tries to discern what they have to say by gauging own feelings or moods, and what that alternative would mean if indeed realized. Especially the two positions “both” and “neither” trigger interesting processes. – Finding one’s role as manager in the midst of many demands: The dilemma of being confronted with the demands of many different persons at once (similar to 360-degree feedback: superiors, coworkers, colleagues, customers, the general public) is set up in the room. The protagonist supplies each position with phrases for their explicit and implicit demands. The protagonist debates with them and decides which demands to give in to, which to reject and which need modification (see also the “Mandate Carousel,” Chapter 4.1.7). – Values and models (acc. to A. Williams, 2001, personal communication): Determining the fundamental values, tenets and principles of an organization and personalizing them with the help of representatives and the protagonist, who then discuss them with each other and with relevant external entities (customers, suppliers, public, sponsors, users, etc.). – Problem constellation (Varga von Kibéd & Sparrer, 2011): Setting up a problem with all its different aspects: goal(s), obstacles, resources, potential gain if the goal is reached, implicit gain if everything stays as it is. – Forcefield analysis: Setting up the supportive and obstructive forces in a current or planned project. 5.3 CircularQuestioning
5.3 Circular Questioning In addition to action-based interventions, asking questions is one of the most basic tools we have in systemic therapy. In the following section, we provide some suggestions on how best to illuminate systems and how to trigger change by asking questions. Taking a look at the various methods, constructions and possible courses through inquiry allows us to develop our own repertoire of standard questions to ask our clients. Yet, we are on very thin ice when we speak of “circular questioning,” since it is a term for which there is no official definition. For this reason, we begin by presenting some background information and then turn to suggestions for classification and examples of questions taken from the literature and trainings. Next, we combine these with our own ideas concerning classification gathered through our own experience. We will not always be able to name the exact origin of the classification or example questions – and do not claim that all examples are our own original ideas. Our main goal is to impart information regarding this tool and not to recount the history of circular questioning.
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5.3.1 How to Construct Circular Questions Below, we list three characteristics used to construct circular questions. We invite the reader to take a closer look at how such questions are formed. Content Circular questioning is aimed at the interactions within a system, especially the interactions between a problem/symptom and the context in which that problem occurs, i.e.: – the relationships of a system’s members and their differences, – their points of view toward and thoughts about the past, the present and the future, – events in the past and present, – reactions to events and differences in those reactions. In systemic therapy we contextualize problems and thus purposefully disturb the viewpoints of the system members, who tend to see their problems or symptoms on an individual level. Circular questions are perfect for this task. That is why they can rightfully be considered the core tenet of systemic work. Case example: Let’s take a closer look at the example introduced in Chapter 3.1.2 – Paul’s family in connection with his “laziness.” There, we explained how to contextualize this problem and how to decontextualize it. Table 11 lists some of the questions one could ask. Table 11: Contextualizing and decontextualizing questions. Example questions concerning “Paul is lazy” Decontextualizing the problem
Contextualizing the problem
To the parents: “Can Paul concentrate on something for longer period of time? How long can he do that?”
To Paul: “Paul, who in your family gets upset the most when you get a note from school saying you haven’t done your homework? Who the least?”
To the parents: “Is Paul restless? Can he sit still for a longer period of time? How long, approximately?”
To the mother: “What do you think – how does your husband view Paul’s schoolwork?”
To Paul: “Why do you do so little school work?”
To Paul: “What would happen between your mother and your father if you were to come home with an F on your report card?”
To the father: “If you ask Paul to bring four things from the kitchen, how many does he actually bring?”
To Paul: “What would you have to do to really get into deep trouble at home because of your homework and schoolwork?”
To the family: “Has an intelligence test ever been done with Paul?”
To Paul: “Let’s assume you suddenly got good grades in school. Who would be the happiest at home about that?”
To the parents: “What did the teachers in kindergarten say about Paul’s abilities and his development?”
To Paul: “How would you have to spend your free time in order to make your mother happy?”
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This is not to say that the questions in the left column are not fitting or poor. Rather, they tend to decontextualize and emphasize Paul’s characteristics and skills. However, if we want to contextualize Paul’s “laziness,” then such questions achieve the opposite of what we’re actually striving for. To that end, we should stick to the questions in the right-hand column of the table (see Chapter 5.3.2 for a list of circular questions according to content).
Background Text: What’s So Circular About Circular Questioning? Circularity is an attitude or an approach to looking at things that reciprocally affect each other. A has an effect on B, B then influences A – at which point everything starts from the beginning. Where the process began can no longer be determined. Graphically, we are dealing with a circular process with neither beginning nor end. What happens is the result of reciprocity (interaction) between those persons or events concerned. An action is the consequence of previous processes and simultaneously the cause of further actions. Any attempt by an observer or participant of the system to define a starting point is purely arbitrary (Watzlawick et al., 2011a, p. 57 ff.). We can experience this when working with systems in many different situations: The quarrel in the schoolyard and the unavoidable question “Who started the fight?” is one example. Or the couple that has drifted apart and asks “How did it all start? What came first, the husband’s withdrawal or the wife’s nagging?” Circularity is the opposite of what we call linear, where it is clear that A is the cause and B is the result: First, the wife nagged, then her husband withdrew (or the other way around?)! Graphically, this may be depicted as a line with clear cause and effect marking the two poles, on which the events are all lined up like pearls on a necklace. Within the circular approach, we study reciprocities – interactions: The wife’s discontent and the husband’s withdrawal condition and reinforce each other. The circular approach allows us to view the events in their context and not removed from their context. The circular approach contextualizes events: The husband’s withdrawal is not a result of his character as such, but has to do with his life situation (his marriage, his job, his family of origin). Similarly, his wife’s discontent is not founded in her character but in her life context. In its original work (Selvini Palazzoli et al., 1981, pp. 132 f.), the Milan team notes that, by asking circular questions, a counselor dives straight into the system’s reciprocity. The counselor’s question is the result of his or her previous perception of that system and the hypotheses drawn from that perception. At the same time, the question effects new processes both within the system and in the interaction between counselor and client, thus leading to new insights. The counselor then either drops an assumption, changes it or feels it confirmed, before proceeding to develop new questions. The process occurring between counselor and system is itself circular. What came first – the information about the system or the counselor’s intervention/question?
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Perhaps some behavior on the part of the counselor led the client to react in a certain way – which caused the counselor to form a hypothesis. But there is another reason these questions are called circular. Circular questions are interesting with regard to – the relationships of the system members and their interactions, – the differences in the members’ mutual relationships and the results thereof, – the differences in their reactions to each other, – the differences in their reactions to the problem, – the differences in their points of view, – possible connections between earlier events in the system and the problem, – and, above all, again and again: the mutual reciprocities of all these factors taken together. A problem is insolubly connected to the context. Its causes lie within the system context, which itself contributes to the the system’s current form. The context, too, is part of the system’s cycles. According to Tomm (1988, quoted after Palmowski & Thöne, 1995), a question is not a circular question “because of its semantic content or syntactical structure,” but rather “because of the therapeutic intention of employing it.” This means asking questions to explore the interactions both within the system as well as between the problem and the interactions in the system, and making them available to both counselor and client. Another aspect of the same thought is that such questions implicitly point toward the connection between an event, a problem and their respective context. Neither suggestion on how to define circularity enables us to make a definitive decision as to whether a particular question is circular or not if the question is viewed independent of the context in which it was posed. A lone question does not reveal, for example, whether the asker – was in a reciprocal relationship with the system the moment it was being asked (Milan group), or whether he – had the intention of elucidating the reciprocities present (Tomm). Taken together, these two positions provide a pragmatic description of circular questioning.
“Gossiping about present company” A further way to construct circular questioning is to ask family members to say what another family member would say or do in a particular situation. The answers to such questions describe the interactions between two family members at a certain juncture or they speculate about the thoughts and feelings of others. Since such questions often concern three people, they can be referred to as triadic questions. Sometimes they are called “gossiping about present company” (von
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Schlippe & Schweitzer, 2007, p. 142). Table 12 juxtaposes some circular questions and their direct counterparts. If we recall the definitions given above for circular questioning, then the questions in the two columns of Table 12 become clear: They all contextualize the problem “Paul is lazy.” Why must it be as complicated as on the right-hand side of the table if things could be much easier and more direct, as the left-hand side suggests? In the Background Text of Chapter 2.3.2, under the title “Differences Are Information – Information Makes Change Possible,” we dealt with the systemic tenet that systems only change through information. By introducing “gossip about present company,” we generate much more information than we would with direct questions. An example: If we ask the father about his opinion on Paul’s schoolwork, we probably get the “official” version of the problem, well-known to all family members from past discussions. No one – except the counselor – learns anything new Table 12: Gossiping about present company and direct questions Direct questions
Gossip about present company
To all: “Here we have a line running through the room. This stands for a scale: One end means 10 = ‘I get really upset at Paul when he doesn’t do his homework. I’m mad as hell.’ The other end means 1 = ‘It doesn’t really bother me if he doesn’t do his homework. Actually, I’m completely unfazed.’ Please mark on the scale where your position is regarding this matter.”
To Paul: “Paul, who in your family gets upset the most when you get a note from school saying you haven’t done your homework? Who the least? Please put your parents on this line, which represents a scale from 10 = ‘I get really upset at Paul when he doesn’t do his homework. I’m mad as hell’ to 1 = ‘It doesn’t really bother me if he doesn’t do his homework. Actually, I’m completely unfazed.’”
To the father: “How do you see Paul’s schoolwork?”
To the mother: “What do you think – how does your husband see Paul’s schoolwork?”
To the father: “How do your react toward your wife when Paul comes home with an F?” To the mother: “How do your react toward your husband when Paul comes home with an F?”
To Paul: “What would happen between your mother and your father if you were to come home with an F?”
To Paul: “What would you have to do to cause your mother and father to really quarrel with each other?”
To the father: “What would Paul have to do to cause you to get into a quarrel with your wife?” To the mother: “What would Paul have to do to cause you to get into a quarrel with your husband?”
To all: “Who of you believe that he or she To Paul: “Let’s assume you suddenly got would be the happiest if Paul suddenly were good grades in school. Who would be the to do well in school?” happiest at home about that?” To the mother: “How could Paul make you happy?”
To Paul: “What would you have to do to make your mother happy?”
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from the father’s answer. But only new pieces of information can trigger change. On the other hand, if we ask the mother what she thinks the husband’s position on the problem is, then – she has to deal with whether or not she should simply repeat the “official” version; – she has to ask herself whether or not she should report other things she’s observed in her husband’s behavior as well as how she interprets his entire behavior toward the problem; – she has to ask herself whether or not her own position toward the problem and that of her husband are identical and where the differences lie; – her husband may wonder how she will answer, i.e., he is concerned with how she sees him; – her husband may have to deal with her speaking her mind and how she will treat such critical matters, how loyal she will be toward him during counseling; – Paul may also wonder how loyal his mother will be toward him during counseling; – the father can, on the basis of the mother’s answer, check how correct his appraisal of her loyalty was; – the father will be particularly interested in whether what she thinks about him is in line with what he had previously assumed she thought about him;7 – Paul will gain some insight into the relationship between his parents and determine whether that information agrees with what he had previously known; – everyone will start thinking about how the problem is related to the parent’s relationship. “Gossip about present company” unleashes a flood of information into a system. And remember: How should a system that is in counseling change if not through new information? This is why systemic counselors so often ask clients or other participants such complicated and irritating questions. But there is another aspect of these questions that irritates clients: Clients are not used to, and sometimes shy away from, speaking about people present in the room, about their presumed thoughts and their relationships.8 This type of question initially causes a dilemma in the persons who are supposed to answer. Sometimes they don’t understand the question, sometimes they think the question is strange, sometimes they’re unsure what is being demanded of them. The counselor should give them time to process the question or, if nec7 R. Laing dealt extensively with what people think other people think about them. Or what they imagine that others think that they think about themselves . . . He described this approach poetically in a volume entitled “Knots” (1972) and later as a complete scientific thesis in Laing et al. (1966). 8 Selvini Palazzoli et al. (1981) hint that they think this taboo is found only, or at least prevalently, in families that have developed problems. It is our observation that the reticence to talk about people in the room is present in all types of social systems.
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essary, explain the question in more detail. But we, as counselors, should not consider the question strange or think the clients too “dumb” to answer our wonderful circular questions. Usually, it just takes some time and patience to allow the clients to become accustomed to voicing such “gossip.” This method has a number of different forms. Here are some examples along with suggestions of purposes they are best suited for. Reading someone else’s mind This type of question is posed to a system member to discover what that person thinks about another system member: – “If I were to pose this question to your wife, what do you think she would answer?” “Tell me, Karen, why is your mother crying?” – “If I were to ask your colleague how the relationship between you and her has been since our last session, what do you think she would tell me?” – “If your husband were here now, what do you think he would say?” – “Robert, what do you think your teacher’s explanation of your problematic behavior is?” Addressed to the teacher: “Why do you think Robert comes to class late?” “What do you think Robert would say to this answer?” If these questions are asked in the presence of the person in question, we can be sure that everyone is paying attention. At the same time, we can assess and further develop the members’ capacity for empathy. We slow down the dynamics of the conversation with such questions. The clients are reintroduced to the experience of their “enemy” listening to them and at least trying to understand them. Misunderstandings are cleared up, allowing curiosity to develop about what the others are thinking and how they see the world. Turning characteristics into behavioral differences These questions look at behavior, not traits: – “How does your colleague manage to turn everything into chaos in the team?” – “What do the grandparents do that makes them so crabby?” – “What does he do so little of?” instead of “When is he so lazy?” – “In what situations does Susie upset her family with her strange stories?” instead of “When does Susie lie?” Traits or characteristics are something you either have or don’t have. They are embedded in your personality, and it is questionable whether they can ever be changed – and if so, only after long and hard work! Thus, progress lies not in dealing with traits, but with behavior, for behavior can be changed. Behavior is something that happens between people; everyone present is involved. And we can study how this behavior arose or what must happen to cause different behavior. If we treat behavior as a trait, we invite a multitude of different interpretations as well as many unverified assumptions. It can be helpful to reverse this process.
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In doing so, we allows people who have been assigned certain traits to understand what the others mean when they say, “He is . . .” The problem becomes more concrete and free of interpretations and implicit assumptions. Comparative Questions This means asking about any changes that have occurred in the relationships or behavior patterns within the system, or about any connections between the problem and recent situations or events: – “When did problem concerning cooperation in the team get worse? When was it better? I’d like to hear several different opinions.” – “When is the father so depressive? When is he less depressive?” – “In which situations are you happier?” – “Nowadays, does your husband support you more or less than he did in the past?” These questions make clients aware of differences that they may not have registered on their own. As such, they resemble questions concerning exceptions: They contextualize the problem by triggering ideas about how the problem may be related to other events. Classification and scaling questions These questions look at the differences between system members and typical changes in the family constellation: – “Who gets along best with mother? Who second best?” “And then?” – “Who is best at cheering up father when he’s depressed?” – “Who was happiest with the earlier therapy? Who was second happiest? And then?” With this method, we can ask a member of the system to present his or her perceptions. These questions can also be staged by drawing a line in the room representing a scale. Case example: Taken from work with the family of a depressive father. The counselor marks off two points in the room with two objects about 10 feet apart. “This side of the scale stands for ‘Is best at cheering up father.’ He gets really happy and can forget his depression for a while. That would represent a ten on our scale. The other end stands for ‘Father’s depression gets worse, turns into a real mental illness.’ That would represent a one on our scale. Bettina, could you please put your family on this scale. Physically place them directly on the scale. And will the others please join in.” After Bettina has set the stage or arranged a sculpture, the counselor says to the other family members: “What do you think of Bettina’s view? What would you do differently?”
Classification questions can be implemented when working on decisions or positions, the goal being to classify viewpoints according to their position on a scale: Case example: “Mr. Miller, let’s try and visualize in a three-dimensional form your position regarding a possible job change. This line on the ground represents a scale, the one end of
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which means: ‘I’ll quit. Better that I go earlier than later.’ We’ll assign it the value of ten. The other end stands for: ‘No, I won’t quit. The risk is too high, I can’t do that. Have to bite my lip and suffer through it.’ That would be one on the scale. What value did you have this morning when you woke up? How did you notice that you had that value? What thoughts were part of the assessment? When was the last time you thoughts were a one on our scale? How did you notice this? What was the situation? What thoughts were you having? – When were you last at a ten on the scale? How did you notice it? In what situation was this? What would have to happen to stay at a five on the scale?”
These questions classify inner states and connect them with various contexts. which makes such inner processes more concrete and contextualized – a great relief to some. Another variation is to ask for judgments and classifications in percentages. Case example: “Mr. Miller, I know you can’t make your decision right now. It just isn’t ripe yet. That’s why you’re here at couples therapy. But, this morning, what percentage of you was in favor of separation and what percentage of you was for staying together? What was the situation yesterday? And the day before that? Let’s try to come to an average for the entire past week.” – “Mrs. Miller, what do you think, how did your percentages look on the days of the past week?”
Questions of agreement and disagreement Such questions are useful for elucidating the situation within a system for all to see: What interests, parties, coalitions and alliances are present concerning the individual themes? – “When Mr. Miller voices his opinion, who from the team supports him and who is against him?” – “Who sees things his way, who sees things differently?” – “Who in the family is of the opinion that your mother and your brother are closer to each other than all others?” – “Who is of the opinion that Patty’s borderline disorder is congenital and who thinks that it has more to do with her development and upbringing? Carl, what do you think? Are your thoughts more in line with . . .?” – During a team counseling session: “I notice most of you agree. Many are apparently of the same opinion as the boss! Are there any dissenters?” – In a family counseling session: “Some of the opinions expressed here seem to say that the father is not consistent enough. What do the others think about this – Peter?” One could, of course, simply proceed by setting up a sculptured staging and asking a member of the system to put everyone in groups, thus creating a very clear picture of the subsystems and fractions. The next step would be having the usual interactions, accusations, reproaches and statements exchanged between the various parties in this constellation. These questions can turn up hidden but vaguely known power plays. Everyone can see which ritualized interactions are holding the system back and how a change in the political equilibrium could help the system.
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Comparison of subsystems Here, the focus is on differences in the functions of various system members: – From conflict counseling at a workplace: “When Ms. Smith has had a fight with her boss, who among the colleagues does she go to?” – “What is the meaning of this group?” – “How does this group support Ms. Smith?” – “How does the boss deal with the situation and with this subgroup?” – “Who else intervenes if things get out of hand?” – From family counseling: “If your brother wants more allowance, who would he ask, your mother or your father?” – “What would your mother (father) do if your father (mother) agreed to a higher allowance?” – “And what would you do?” – From couples counseling: “If you are having a fight, what are the children doing during this time?” – “How do they react?” – From family counseling: “Who worries more about the grandparents, the parents, the children?” – “How do you notice that?” – “What do the worriers usually do when they are worrying?” – “How do the others react to the worriers?” This, too, brings the subsystems to the surface, similar to the questions of agreement and disagreement. The political aspect is not the main point, but rather the functions of the subgroups and how their combination causes change and typical interaction patterns in the system. “What if . . .” Another group of questions concerns what might be possible: chances, rough drafts, the hypothetical. Examples of such questions can be found in Chapter 5.3.2 below. Basically, they ask what life would be like if – a solution were available, – an improvement were present, – the problem had gotten worse, – something else had occurred. These scenarios should be worked out on a concrete level in order to bring the clients to concern themselves with them. Here, too, we are dealing primarily with the context of a problem, the temporal context of the future in light of some sort of change and its repercussions. The change can be realistic or not – imagination is what’s required here in order to learn more about the system, the contexts and possible solutions. Clients may become a little irritated at these questions and consider them a waste of time. Some think working on a problem means dealing at long length with the suffering. Any method that proceeds without this sort of examination is thus immediately suspicious – it’s too easy, too playful almost. Some may feel they and their problems are not being taken seriously when the counselor suggests that they daydream and speculate about a brave new world. Their comments show what they think about such nonsense: If I were the king of the forest . . . Of course, there are also counselors who are not especially attuned to such
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approaches. Haven’t we learned that all medicine must be bitter? Doesn’t healing happen through suffering, salvation through sacrifice? Once again: The most important thing is one’s own conviction that the path one is taking can be effective. And it is necessary to be critical toward one’s own preconceptions of how healing, deliverance and salvation can occur. One has to be steadfast and not be irritated by the clients’ irritation. Invite the clients to come along and motivate them to go down this new path. It might be helpful to explain how and why a particular path can lead to solutions. Yet there are also contexts and situations in which problems are simply problems and have to be recognized as such (see the Background Text “Solutions Are Important – and so Are Problems” at the beginning of Chapter 5). Background Text: How Circular Questioning Works What do systemic counselors think circular questioning actually achieves? First, we can point to two effects already mentioned in the previous chapter: – Circular questioning produces a cascade of new information on the relationships among the clients. This information, in turn, changes the perceptions of all those involved: Some old perceptions are deconstructed so that new ones can be constructed. Changed perception enables changed behavior. – Circular questioning contextualizes the problem. The cause of the problem is no longer thought to be located within any one system member. This motivates everyone to concern themselves with the relationships that exist and, if possible, to do something about them. There are, of course, other ways to effect change that also involve circular questioning. Circular questions are also reframings! Perspective changing is also furthered when a question indirectly injects new ideas for everyone to ponder. Every question contains assumptions that flow into the conversation. Questions can even be used pointedly to introduce new ideas. They change the frame of reference of the system – they “reframe” the system (see Chapter 5.4.3). In the following, we present some examples of reframing that are indirectly contained in circular questioning. The contextualized framing of the problem: Circular questioning is based on the assumption that every problem is connected to the context rather than individual traits. If we ask circular questions, the system members will automatically adopt these implicit assumptions and discover other hints that point in that direction. The counselor must not openly introduce a new thesis. Rather, after a longer circular conversation most clients will have discovered the connection on their own and are convinced of the thesis based on the previous discussion.
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The good in the bad: A problem is often observed only from the troublesome vantage point, ignoring the value and advantages it may offer to some or all individuals involved. Case example: Old construction: The mother repeatedly comes down with a psychovegetative fatigue syndrome. She and her entire family suffer during these times. She is irritable, short-fused, has nervous breakdowns, cries and screams a lot. Clearly, something has to change. Reframing: “Who first notices that mother is getting irritable because she takes such good care of her family?” – “Who is relieved the most when she takes too much care of her family?” – “When mother is taking such good care of her family, who is she helping most – even though we all know that she shouldn’t be doing so much for the family because it makes her so irritable and exhausted?” Case example: Old construction: Paul is lazy at school, which is a bad thing and has to be changed. Reframing: “Who in the family would benefit from rebelling like Paul against the pressure to excel and become overworked?” – “Let’s assume your parents no longer had any reason to fight about Paul’s laziness. What would they fight about then?”
Turning victims into culprits Case example: Old construction: Father suffers from depression. Reframing: “When does father decide to become depressive?” – “What would he have to do to be depressive tomorrow?” Case example: Old construction: Everyone in the family is always upset about Peter. He makes mistakes, can’t concentrate, loses things. Reframing: “What else could Peter do to get this much attention?” – “Let’s assume it was a contest of who the family worries about most. What place would Peter win with his behavior?”
Turning traits or things into behavior or action Case example: Old construction: Paul is lazy. Reframing: “How does Paul do his laziness thing?” – “What does he do when he’s being lazy?” Reframing: “Let’s assume he wanted to act as though he’s being lazy. What would he have to do in order for his mother to notice and get upset with him, just like she usually does? What would be the quickest way for him to achieve this?” Case example: Old construction: One of the colleagues, Mr. Miller, is such an insensitive person. His behavior puts a strain on the overall cooperation in the workgroup. Reframing: “Please list some of the little things Mr. Miller did within the past 3 days that made you notice how insensitive he really is?” – “In these situations, what would he have had to do to make you think: He’s not as insensitive as we thought he was!” – “Are there also things that he does that make you notice that he does have a sensitive side?”
All of these questions imply new ideas that, at least in part, contradict the previous constructions of the system. Every question transports some implicit assumption. The decontextualized questions in Table 11 carry with them the
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assumption that the problem lies within the nature of the person and not in the context. By addressing the system with such questions, we direct the attention in this direction and automatically stabilize this way of seeing things. When we, as experts, ask the system questions with implicit assumptions, this position gains weight and “truth” within the system because of our status as experts. Of course, we are manipulating the system in this manner – something that can hardly be avoided. This is why we should use this method both consciously and responsibly. Circular questioning gently tests the counselor’s hypotheses From the system’s reactions the counselor can judge how his or her assumptions and hypotheses fit the system. A sequence of questions usually serves to test a hypothesis. Such hypothesis-generated questions have the advantage of causing the members of the system to also start deal with the counselor’s hypothesis. They think along the same lines and become interested in whether the implications of the hypothesis are, indeed, true. The clients can decide for themselves what conclusions to draw, without having to take a public stand on matters. This saves the counselor from confronting the system directly with the hypotheses, and it saves the clients from having to openly take a stand. Often it suffices to end the sessions by asking what the individuals’ take-home message is. The utility of “what-if” questions This type of question makes counseling easier and more creative, and it allows us to determine the interactions between the problem and the context. It can be traced back to solution-oriented short therapy as propagated by Steve de Shazer, Insoo Kim Berg and others in the 1970s and 1980s. It is based on the conviction that – a conversation about problems causes more problems, whereas a conversation about solutions brings forth solutions; – solutions do not necessarily have anything to do with the problems at hand, and a lengthy and detailed analysis of the problem does not necessarily produce a lot of suggestions for a possible solution; – it is easy to lose your way in the complexity of the problem without ever finding the exit, whereas solutions are often relatively easy to find. Whether one pushes the problem aside or devotes much time and effort to the problem in systemic counseling, “what-if” questions are always useful because they actively help to construct solution scenarios. Ideas for solution – at least in the minds of the clients – become more probable and more conscious. Dealing intensively with a problem can, of course, lead to a fixation on the troubles. The problem can suck us in without our ever coming closer to solving it. A more relaxed and creative atmosphere is helpful in finding solutions. Above all: The solution must first be thought of before it can be executed.
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5.3.2 Problem and Resource Contexts: Using Circular Questions How does one best use the above-mentioned forms of questioning when working on problems and system resources? The following classification of discussion topics also contains some suggestions for organizing conversations. However, one need not work through the individual discussion topics in a certain order. Rather, they can be addressed depending on the situation and the counselor’s hypothesis. Some of the listed question categories may fit the exploration. We also provide some comments concerning how to best construct circular questions. Description of the problem and the participants It is worth taking time at the beginning to investigate exactly what the problem is and who is concerned with it. We ask the participants how the problem arose, from what or from whose behavior. And we ask what other people would say the problem is. – When, how often and where does the problem occur? – When and where does it not occur? – Who is more and who is less affected by it? – In whose presence does the problem occur? – In whose presence does the problem not occur? – Who is affected or involved? – Who would deny that there even is a problem? Questions such as those discussed in the section above, “Turning characteristics into behavioral differences,” are very useful here. Further, we can pose agreement/disagreement questions as well as questions comparing subsystems and “gossiping about present company.” Case example: “Claudia, could you please set up your family members in a row. At the one end, put the person from your family toward whom your brother Peter is most hurtful, angry and quick-tempered. At the other end, put the person toward whom he shows this behavior the least.” – “Thank you, Claudia. Can you now please tell me why you chose them as you did? That is, give me some examples of how Peter acts toward your father and why you think that is especially hurtful, angry or quick-tempered.” Case example: In conflict counseling of a team: “So that I have a better understanding of the situation, Mr. Mason, could you please reveal once again who from the team would say the following: ‘Karen sees to it that she isn’t overworked, and that is a problem for everyone.’ And who would say: ‘The way she does things is OK – it’s fair toward others, and I can live with that.’” Case example: Or on another topic: “You say that the information flow is not functioning properly, and that this is a problem. Let’s look at that more closely. Ms. Clear, can you please set up a rank order of team colleague pairs that represent the perfect data gravesites. Choose pairs of colleagues between whom information – even the important stuff – is quite likely to get lost. For the other end of the scale, pick out those pairs that rarely allow information to get lost between them. Of course, some colleagues may be present in more than one pair.”
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The miracle question, which we discuss in detail below, can also be posed to make the problem more concrete: – If a miracle were to occur within the next few weeks, how would you notice that the problem had been? The dance around the golden symptom Symptoms and the symptomatic persons in a system tend to create typical, recurring interaction rituals that give the symptom a special meaning. That is what we mean by “dance around the golden symptom.” In a real dance, the dance steps are well-known to the dancers who have to keep up the proper rhythm. The same is true for symptoms. Sometimes the image of a theatrical play is also helpful: The counselor discusses with the participants what makes up the first act, the second act, etc., as well as how to structure the beginning, the climax and the course of the play. To investigate such dances, or plays, the following questions have proved useful: – Who reacts most to the problem? Who reacts the least? (comparative/classification and scaling questions) – How do the others react to the problem? (agreement/disagreement questions) – How does the affected person react to the reactions of the others? (can we identify a cycle, an interaction pattern?) – How do the others behave toward each other when the problem occurs? (What type of dance do we find?) Case example: From family therapy: “Ms. Mayer, we now have an idea of how your son Peter has been acting, so hurtful, angry and quick-tempered. Your daughter Claudia placed as opposite ends of a scale the person he treats this way the most and the person he treats this way the least. Everyone agrees that Peter acts this way most toward his father. How does your husband generally react to Peter’s behavior?” – “And Peter – what does Peter do then?” – “Claudia, do you see things the way your mother does or would you describe the situation differently?” – “Peter, what have you noticed about the way Claudia and your mother act while you’re busy with your father?” – “Mr. Mayer, do you agree with Peter or do you observe something different about your wife and Claudia when you and Peter are so intensely occupied with each other?” Case example: From conflict counseling of a team: “Mr. Thomson, if a part of the team is of the opinion that your colleague Karen is too easy on herself and successfully avoids doing more work, how do these colleagues react? How could one notice that they are of this opinion that something is askew, as often is the case?” – “What does Karen do then?” – “And how do the colleagues of that fraction react?” – “And Karen, what does she do next?” – “The other colleagues, those who do not think that Karen is unfairly avoiding work, what do they do in such situations?” – “And what do you observe – what effect does that have on Karen and the other colleagues? Do they react or not? And how do they react?”
One way to continue working on the “dance around the golden symptom” is to look at all the exceptions to the way things normally go – including “gossiping about present company”:
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– Do things always develop that way or are there exceptions? – What do these exceptions look like? – Which exception is more positive and which more negative than the usual course? – What does the person affected by the problem do differently than usual? Does anyone have any hunches about when and why that person does things differently? – What do the “dance partners” do differently? Do they have any hunches about when and why they do things differently? Case example: From couples therapy: “Ms. B., we have now discovered how arguments with your husband continue to escalate until you once again reach the point at which you want to get a divorce and he leaves the apartment for a few hours to cool off. But do things sometimes go differently?” – “This rare course, as you say, is more agreeable to you. What does your husband do differently in these situations?” – “Why do you think he is able or wants to act differently in such situations?” – “Mr. B., what does your wife do differently in these rare situations?” – “Under what conditions does she act that way?” – “What have you both learned from our discussion about the exceptions to the usual dance you both take part in? I would like each of you to answer for him- or herself.”
Part of working on the normal (and sometimes awful) “dance around the golden problem” may be asking the partners what would have to happen for them to stop their usual dance and try some new steps. Then we employ a well-known example. Case example: From family therapy: “Claudia, we have now learned that your father sometimes reacts less intensely to Peter’s provocations – and that this leads to a better result. What do you think your fathers needs – from your mother, from Peter or from you – to be able to react that way?” – “Do the others agree or do you have any other ideas on this?” – “Mr. Mayer, is what Claudia’s saying correct?” – “And Peter, do you also think that way?” – “Ms. Mayer, we have now learned that Peter does not always have to provoke your husband and counter your husband’s reaction so fiercely. What could your husband and you, Claudia, do to help Peter decide not to react so strongly?” – “Peter, what do you, yourself, think would help you? And what, on the other hand, would cause you to react strongly?”
We use this variation very conventionally to eliminate symptoms, though there may be good reasons for things to stay the way they are. This is why one should not repeatedly head down this path if previous attempts have failed. Here, as so often in life, we should think of Watzlawick’s words: More of the same usually leads nowhere if previous attempts were unsuccessful. The past: Problem history Asking about the history of the problem tells us something about both the origin and the course of the problem – and gives us numerous hints about the best and worst contextual conditions. Thus, we ask various members of the system the following questions to obtain a variety of descriptions: – How and when did the behavior first appear?
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– Who was the first to call it a problem? Who was next? And then? – Was anything special going on at the time (strained life situation or relationships)? – Did something happen shortly before or during the development of the problem? – Were the reactions to the problem back then different than they are now?
For this purpose we use special classification, scaling and comparison questions. Case examples: “How did your wife react when your child first was so afraid that she couldn’t sleep alone in her own room?” – “And your husband, how did he react at that point?” – “Was your reaction to your daughter’s refusal to stay in her own room alone different back then than it is today?” – “What and why did you begin to react as you do today?” – “Do you think your wife was the reason for reacting differently to the situation?” – “What did your husband do back then when you changed your reaction to your daughter’s refusal?”
Here, too, as in most systemic work, we are interested in the exceptions to the rule, in order to learn – together with the client – how the problem can best be attacked. – In which phases (how long and when) did the problem recede or cease to exist altogether? – What were you and others doing differently during such phases? – How did you manage not to let the problem occur at certain times? – How do other things in your life change when the problem recedes or disappears during such phases? The goal of such questioning is to connect the absence of symptoms and successful coping with certain contextual circumstances. This allows us to take a closer look at how certain contexts positively impact the problem. Here, too, one can close the conversation with the question of what those concerned can learn from the past. Exploring previous problem-solving attempts We consider this avenue to be especially important with chronified problems since many different professional helpers must usually be brought into the picture (see Chapter 3.3.3). But there are other situations in which it can be equally helpful to explore with the system which steps have already been taken in the past and what the results of these efforts were. – What have you tried on your own to solve the problem? What attempts were made and what did you learn from them (both negative and positive)? – What did others in your environment do to solve the problem? Describe the attempts and what you learned from the attempts of others? – What professional helpers have been involved to date?
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– Who invited the helpers? When? Why? – What was the result? – What did the other helpers have to say about the problem? What did you learn from previous helpers? – How and by whom were these previous contacts ended?
When problems have chronified, it is our experience that those involved do not have a clear picture of everyone who has attempted to intervene, who initiated the intervention, who broke it off and why, and what the helpers thought about the problem. For that reason, we recommended in Chapter 2 and 3 to get to the bottom of this matter and put it into a timeline. To this end, “gossiping about present company,” reading thoughts and scaling questions are very well-suited types of questions. Case example: Once again, the example of the Mayer family with Peter as the problem child. “So you were at a counseling center about a year ago to address this problem and had a few sessions with a social worker. The father, mother and Peter were present. Claudia, do you remember who thought it was important to go to counseling?” – “Why was that the case and why was it not very important to your father?” – “How did the whole thing end, Claudia?” – “What did your mother and Peter say when your father voiced his desire to end the counseling?” – “Mrs. Mayer, why didn’t your husband want to continue counseling back then?” – “What would I have to do, Mrs. Mayer, to make your husband want to quit coming to me as well?” – “What do you think I would have to do in order for Peter to want to quit coming here?” – “Mr. Mayer, what could I do that would make your wife want to stop coming here?” – “I would like to know from Peter, his mother and his father, what my colleague said back then about the origin of the problem and what others thought about this.” – “What did you, including Claudia, learn from my colleague’s attempt at intervening – both positive and negative?” – “What can I, as the new helper, learn from how my colleague reacted and do better today?”
Studying other professional helpers’ attempts at solving the problem can help us learn more about previous interaction patterns between the system and helpers and avoid such pitfalls ourselves. It is worth investigating this point thoroughly to avoid clients simply “consuming” one form of professional help after the other. Differences in explanations and solutions to the problems The way one looks at a problem also determines how one approaches the solution. Explanations steer our attempts at helping in a particular direction. Anyone who thinks depression is a contagious disease will be reluctant to speak at length about relationships. But this is precisely where systemic therapy steps in and determines, together with the client, why the person is not open to other explanations – why that person is susceptible at some times and not at others. To this end, it is often best to find out what these views really mean: – What do you believe the people in your immediate surroundings think about the background and causes of the problem? What do you yourself think? Does anyone in the family share your position?
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– What do you think the persons in your immediate surroundings believe would be a good solution? And who would have to do what to make the problem disappear or at least to invoke positive changes?
This is exactly the point at which mind-reading questions come in handy. Once you have gained some orientation, you can continue with questions concerning agreement and disagreement. The various approaches to what caused the problem and how it can be solved are very important to the counseling situation. Who does the counselor support and who will be proved right in the course of counseling? For this reason, it is advantageous to work on clearing up the “political” situation in the system. After exploring the issues of agreement and disagreement and establishing the different positions concerning cause and solution, we can continue counseling by looking at the functions and interactions of the various subgroups. How do the different groups and their interactions affect the system? What effect do they have on the expectations toward the counselor? Depending on the case at hand, the next step could be to continue with a “dance around the golden symptom.” Asking the system about resources This line of questioning is extremely important, yet counselors are often tempted to limit the amount of time for this step since everyone, especially the clients, are eager to work on the problem itself in light of the level of general suffering. Still, this is an important task because systems that have been burdened by problems they are unable to solve on their own, may have sustained damage to their “selfesteem,” as it were, leading to self-deprecation: Case example: Both partners consider their marriage to be rather useless and more a hindrance than a blessing. It is a marriage in which sex has played a minor role for a long time now, and the entire relationship just doesn’t seem to be working out. Still, they are able to organize daily life quite well and agree on many important things such as money and possessions, childrearing and housekeeping. Awareness of the fact that they can continue to live together peacefully, however, is lost or disregarded. Case example: The problem is that the leadership fails to support the team, fails to acknowledge its achievements and, on top of it all, makes new demands while also cutting their salaries. One colleague finds her job to be uninteresting and stressful, especially since she’s now involved in a dispute with her superior. She may get fired. What she fails to see is that the job offers her a broad range of freedom and autonomy in how she does her work. In fact, the deteriorating working conditions are not limited to this particular company, but rather concern the entire industry. In fact, in her company, they are relatively moderate. Also, the atmosphere among her and her immediate colleagues is still pretty good.
The positive things are simply being overlooked. The system is being devalued, and the depiction doesn’t tell the whole story. This can easily lead to false decisions that are quickly regretted. Belonging to a devalued system (even if I am the one doing the devaluing) harms my own sense of value (see Chapter 5.4.2). It is
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easier and more productive to work with clients whose self-esteem is still intact! This is why the counselor should work on emphasizing the system’s resources. However, there are clients who come to counseling and are unhappy when one launches off in this direction: – They are under extreme pressure for things to get better quickly. And how do things get better (at least according to most people)? By talking and working through the problems intensively and at great length – not by starting off stressing everything that’s fine in the system. That’s all been said before! – In their inner dialog, and in conversations with others, they have grown used to griping profusely about their marriage, their job, their boss, their colleagues. It’s become so easy by now. Questions about their resources catch them off-guard. What a nuisance! – The commonly held view that modesty is a virtue and one should not emphasize one’s own strengths and successes sometimes forbids this endeavor. For some, it is unfamiliar, for others taboo. But here, too, it is important that the counselor tolerate the client system’s resistance. Usually the mood changes once the clients have gotten through the first few points: Talking about strengths actually can be quite fun. Of course, the counselor has to learn to embrace this procedure as well. The following questions, similar in style to “gossiping about present company” and mind-reading, can be of help: – What are the strengths and capabilities of those concerned? – What is successful in your family life? – What should stay the way it is and not be changed? – What were the happy and successful times in the life of the family, team or organization? What were the highlights of the past 2 years? – What has helped you to go on despite the problems? – What support did the system get from family and friends? – What ideas and beliefs empower the family/team? If the problem were suddenly to disappear This type of question, taken from solution-oriented short therapy, is classically called the “miracle question.” Since then, magicians, fairies and other wonderful creatures regularly pop up in systemic counseling. Whenever this is the case, pleasant and creative conversations ensue. Or it causes irritation. The idea is to lead clients away from their problems and down a path of imaginary solutions. This is possible with any number of questions that, depending on the client, more or less address the possibility of miracles happening. Through this sort of questioning, we invite the clients to imagine the problem had disappeared and were no more. Supplementary questions by the counselor help the client to develop very concrete and detailed ideas about what life might look like then. The following questions have proved useful:
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– Suppose tonight a miracle were to happen and the problem were to disappear (because you were kissed by a fairy, had an operation, God’s intervention, whatever). – How would you notice, upon waking, that the problem had disappeared? Exactly what would have changed to make you notice? Would your thoughts be different, would your physical feelings? What would you do first on such a morning? What next? – Who would be first to notice that the problem was gone? Who next? (classification/scaling questions) – What would you miss most in your “new” life if the problem were gone? – If counseling is successful and you have solved most of your problems, what would your life look like? What would you do differently than today? – Supposing you were to succeed at doing less of one thing or more of another, what would be different in your life?
In this process, it is sometimes good to ask the clients which physical sensations would reveal that the problem had, in fact, disappeared. The most important thing is that the clients imagine the situation concretely and graphically. Case example: Taken from couples therapy: “In our therapy sessions, we have discovered that you spend about an hour a day in your own inner room, watching your husband with great skepticism, angry at him, feeling hurt and jealous. There are pictures on the walls of this room, showing him together with other women, during real or presumed affairs. Your husband immediately notices when you’ve entered the room, since you reject him, become aggressive toward him and all the fun goes out of your relationship. Let us suppose that this room were to disappear tonight, say, through a miracle. Gone. Untraceably gone. Whether you wanted to go in or were forced to enter, it would be impossible because the room is just not there any longer. When you wake up the morning, what would cause you to notice that the room no longer exists? When would you first notice it? At what juncture? How would you notice it?” The client was able to pick up on this idea and develop in her imagination a life without the room. At the end of the session, however, she decided that she didn’t want to live without her room since it offered her a certain sense of security in life – something she wanted to have. Still, her relationship toward the room had changed: She no longer felt the pressure to be in the room and no longer suffered because of the room. She was also no longer angry with her husband because he had contributed to the existence of the room. Rather, the room simply held a protective function for her. Nevertheless, she found herself going to the room less and less and experiencing it less intensely. The interaction with her husband became less destructive and more bearable for him. He learned to deal with it better.
One can take things to a higher level by displaying interest in further consequences of the disappearance of the problem: – How would others notice that things had gotten better or the problem had been solved? – Who would be the most surprised? (scaling question) – Who would react how and why if the problem were to disappear?
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– Who has a vested interest in such an event? Who doesn’t? Who would be faced with more disadvantages than advantages if the problem were solved? (agreement, disagreement, comparison of subsystems) – Who gains, who loses, who doesn’t react at all to the disappearance of the problem? (classification and scaling)
Sometimes it is worth one’s while to employ these questions at the very beginning of therapy to clear things up. The miracle question need not always be treated as a major intervention. Case example: Taken from the beginning of a case review session involving a very difficult course of events: “Imagine, if you would, that our case review were over and had been extremely successful. It had taught you a lot, but now it’s over. What would be different at that moment? When would you notice the effect of the session? Immediately? During the next meeting with the client? How would you notice that the session had, in fact, been such a great success?” – “So you felt less pressure during the next session with the client? How did you notice that the pressure had receded? Physically? What felt different?” – “What thoughts had disappeared, what new ones had arrived instead?” – “What do we now have to do in order for the pleasant feeling to return quickly? What do you want from us to ease the pressure?”
Speculating about changed contexts Such “what-if” questions allow us to play out any number of scenarios in which the counselor and the clients together regard the effects of certain changes. One can also take a trial run of possible future drafts. Or one assumes that something was different in the past that would have certain consequences for the future. Such methods provide the clients with experience and insight into how problems and contexts are interconnected, how exactly one specific problems “fits” the present context, and what the effects of any changes to that context would be. Even the positive sides of one’s problems can be discovered and emphasized! Case example: Taken from team supervision: “You complain about the leadership of the team and your department. There are too few commitments, too little structure in the meetings, no agenda, no minutes, no evaluation of results. One day something is of grand importance, the next it’s been forgotten completely. Let us assume you were to refuse to play along, you ask again and again about the meeting’s agenda, ask why something so important one day can be minor the very next. Everyone here would act that way, not just one person. You simply wouldn’t go along with it, you would disturb things and cause complete disarray. What would happen? How could you do this in such a way that you’d get the biggest reaction, that you’d destroy the old order so that it no longer worked?” Later it turns out that there are, and always were, alternatives, ways to change the game from the employee position. The cost, however, may be that a conflictual atmosphere had been created in which most privileges and perks afforded by management were absent. Also, it was found that there was little practical solidarity within the team in concrete situations. If one colleague demands a commitment from management, the others do not back him up: Some keep still, some say they fail to understand what’s going on or know too little about the situation, whereas others claim rather to sympathize with the management’s
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position. So the one who voicing dissatisfaction is left out in the rain – although after the meeting he gets support from his colleagues that he was right about what he said and how brave it was of him to have said it. Many new ideas and approaches to the formation of a common opinion and a new position became possible because of these different perspectives. Case example: Taken from family counseling: “You are convinced that your husband is not assuming enough responsibility for the family, the children, the household chores, but rather leaves it all to you. Let us all imagine for a moment that you go to live in Australia for 9 months – you have to pick up and move. Your husband stays back and has to fend for himself, no way out. I would like to hear from you and the children what would likely happen at home during this time. What would life look like? What would go well, what would go poorly? How would their life look in, say, the 8th month of your absence?” – “Those are very interesting ideas, but let us go a step further. I would now like to ask the children to join the father in this session and think about how things would go at home during this period of time in which your mother is in Australia. Try to imagine very concretely your everyday life. Could you do that for me? Your mother and I will take a seat over here and just listen to you.” Case example: Taken from family counseling: “Ms. B., you said that it just wasn’t working out with Bill at home, and apparently Youth Services agree. What if your son Bill were to be put in a home. How would things change for the rest of the family?”
Questions about future changes can also extrapolate the problem into the future: Case example: “If I were to say to you that the problem is unsolvable, how would you react?” Or: “If nothing were to change and the problem were to continue to exist, what would family life look like in, say, 5 years’ time?”
We can also propose hypothetical changes that concern basic, existential elements of the clients’ lives, even if they are completely unrealistic: Case example: A family is in counseling with their 22-year-old daughter who, since the age of 16, has kept the family (father, mother, 20-year-old sister) occupied with many rounds of interventions by Youth Services and stays in psychiatric hospitals (the mother, too, was in therapy for a long time). The following question is posed to the 20-year-old sister: “Let us assume that your sister had not been born. What do you think would have happened in the family? Would family life have been different than today?” To the elder sister: “Let us assume you were an only child. How do you think that would have affected the family history and your history in particular?” Case example: Taken from couples therapy, addressing the wife: “What you say often sounds to me as though you’ve still got a lot of living to do. Let us assume you had not met your husband, had not met any man at all or had taken an oath not to enter into a partnership of any kind – where would you be today? How would your life have progressed? What would you have done over the past 15 years?”
Such interventions demand a clear target on the part of the counselor. The counselor must suggest what would be different and give the system a limited time to flesh out the new scenario. If that succeeds, clients can develop a number of new viewpoints toward their own system, toward the positive role their problem plays,
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toward their own responsibility, toward decisions that one unconsciously makes to adopt a certain behavior and toward alternatives. Such interventions stimulate one’s imagination and raise one’s level of creativity toward solving one’s own problems. Exacerbation questions But of course one can always find something that would make things worse! To pose such questions may appear unseemly, and in some cases it may indeed be unfitting or disrespectful. However, if the counselor feels comfortable with posing provocative and bold questions, such questions may, in fact, further our knowledge about the problem at hand: – What would you have to do to keep the problem alive, to cement it forever, to make things worse than ever? What would others have to do to make things even worse? – What could you do so that others act a way that makes things worse? – How could you make yourself completely unhappy if that’s what you wanted? – How could others help you to realize your plan? – How could you invite others to help you to make your life miserable? After an initial moment of irritation, clients usually experience a relaxed, creative atmosphere which in and of itself is a valuable tool. The necessity for changing, for bettering oneself, for working hard at finding a solution – all this self-coercion into just being reasonable – takes the back burner. Instead, the conversation becomes markedly light (sometimes with a hint of the macabre) – a change that produces new insights. The most important facet of reframing inherent in such questions is the assumption that the client can, in fact, influence his or her problem/symptom and is not only a victim thereof. This implicit vantage point is anchored with such questions. And what can flow in one direction can likely flow in the other as well. In such discussions of their problems, clients experience themselves as active, not passive. What is the problem good for? Some of the questioning methods introduced above channel the dialog to the point that the utility of the problem/symptom becomes visible. The counselor can then seize the matter directly and take it even further. However, the type of questioning discussed in the following cannot be “cold started.” It needs a certain measure of preparation by means the previously introduced methods to function properly. It is important that a certain level of contextualization has been reached and the “dance around the golden system” is apparent to all. Otherwise, the whole matter can become artificial and useless if it is not intimately connected to the clients’ inner state of being. With the following questions one can elicit the utility of symptoms:
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– Who would profit if the problem were to stay around a while longer? Or from having it just flare up once in a while? – What would be worse if it were completely gone?
Here are some examples from previously mentioned counseling situations showing how to delve more deeply into the question of the utility of a problem: Case example: Taken from couples therapy (see above): Via the miracle questions the wife has discovered what it would be like to escape her unhappy situation – but also that she is, in fact, unwilling to dispense completely with all aspects of the situation. Here, the question was why she didn’t feel that it was the right time to get rid of her “inner room.” She saw the rationale: It provided her with a sense of security toward her husband. It helped her feel less at his mercy and less dependent on him. Within this inner room, the idea of separating from him and living alone with the children appeared acceptable. It motivated her to seek out and further develop her own social contacts. It helped her to do more for herself and to stand on her own two feet economically. And in the last few years, it had increasingly provided her with her own lifestyle. In the first years of her marriage, she had attuned her life and organized family life completely around her husband. Now she wants to be informed and participate in all decisions. She fears losing all of this if she were to give up her inner room completely. Case example: Continuing from Chapter 5.3.2: Here we were dealing with a team that was suffering under its leadership. The “what-if” question clearly showed the benefits the problem has for the team. A back-scratching culture developed. The existing criticism of the lack of commitment on the part of management and its poor planning remains unspoken. On the other hand, management provides the employees with considerable space, does not demand commitment and gives the employees numerous perks. This would all be lost if the bemoaned stagnation were to come to an end (and with it, the team’s dissatisfaction).
It is a very important element of systemic counseling to determine together with the client system the meaning and utility of the symptom. The symptom is an integral part of the system. It is not possible to change part of the system without triggering changes in other areas as well. One begins this approach through the use of such questions. Asking about the utility of the symptom or about how best to exacerbate the symptom is especially well-suited to keeping the counseling process from drifting off in the sole direction of changing or eradicating the symptom. That would serve only to strengthen the persistence inherent in the system and to sustain the system’s previous state of equilibrium. These forces would then very effectively sabotage any changes brought about by counseling. There is a variation in this questioning method, namely, asking how long the client thinks the problem will be needed or remain useful: – How long do you reckon you can provide space for the problem in your surroundings? – When will you give it notice to move out? – If you do nothing, would the problem disappear of its own accord?
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Future plans for the problem and the rest of life These questions concern predictions about one’s own life and invite us to ponder the meaning of possible developments and to anticipate the effects of certain events. In contrast to questions posed by the counselor relating to hypothetical changes, these questions deal with real and foreseeable occurrences, for example, children moving out of the house, moving to another city, retirement, death of the grandparents, or changes in one’s economic situation. Case example: “You seem to be having a lot of arguments about the children who still live at home. Which child do you think will be the first to move out and when? Who’s next in line? When will it be just the two of you at home, and how do you think it will be, living without the kids in the house?” Case example: “There is presently considerable insecurity in your business due to the restructuring process going on. That I have understood. Let’s suppose this phase has passed – according to your calculations sometime next year. When everything is finished and a routine has returned, how do you think things will be? Who will be doing what? Who will be conversing with whom? What will the work situation look like? Let’s use your life and business experience to predict what’s to come.”
One can look at very different timespans, depending on the person in question. During crises one usually shies away from even pondering anything in the future – something that creates a certain distance from what is presently happening. Asking about a “conscious or faked relapse” Here are some example questions of this nature: – If you have said goodbye to your problem ages ago, but then wanted to “recall” it, how would you go about doing that? – If you want others to think that your problem has returned, even though this is not the case, how would you do it? – Would other people recognize that your problem has returned or whether you’re bluffing? – If you were to be rid of your problem once and for all, what are some situations in which it would be practical to have it reappear? This type of “what-if” questioning frames the person’s active relationship with the problem, which one willfully controls. But another more implicit message is also transmitted by such questions: The symptom has its own inherent usefulness. You only invite people into your home who somehow belong to you, who have at least a few redeeming sides to them. The symptom is part of the system. Such questioning is not always easy for clients to handle. Some beliefs work against these constructions: It’s not right to feign suffering and problems! That’s not acceptable! You don’t invite suffering and problems into your life! Quite the contrary, you’re usually happy when they disappear! There is also the superstitious variation: If you say something out loud, then it will happen and come back to haunt you. Here, too, the task is to take the time to explain and invite the client to talk about these matters.
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5.3.3 Two Suggestions for Dealing with Circular Questions Prepare the questions carefully Proper use of circular questions requires much practice and good preparation. This is true especially when using the method for the first time. Based on our experience as trainers one should assume that, at the beginning, preparing for a session may even take longer than the actual session itself lasts. Why is that? Above we explained that with this type of therapy the counselor translates his or her own observations (and the resulting hypotheses) into questions that serve to test the hypotheses. Thus, preparing for a session means – reviewing all the relevant information one has gathered in previous contacts about the system, such as expressed facts, observations, or one’s own feelings; – reviewing one’s own assumptions about the system (however vague they may be); – deciding which assumptions to test in the upcoming sessions; – checking whether the hypotheses chosen are included in the contract; – pondering who will exhibit the greatest resistance when the chosen hypotheses are tested (political aspect of the system) and developing a plan to deal with such developments or how to make the situation acceptable to all members of the system; – deciding which questions to ask and whom to ask them. We emphasize a thorough preparation so much because beginners, especially, tend to underestimate how much time this takes and how difficult it is to deal spontaneously with the results of such questioning during the actual session. In this context we would like to mention again the article by the Milan team (Selvini Palazzoli et al., 1981), which describes how intensely the team discussed and evaluated an application given over the phone. Despite the lack of hard and fast information, they generated hypotheses, planned the session down to the last detail, discussed which types of questions were to be used and who would be questioned. They agreed that two of them would conduct the interview, with the others standing behind a two-way mirror. During the sessions, the counselors even left the room to discuss among themselves and with the observers how to best proceed with the session. These standards differ greatly from the way systemic therapy is done today. Our intention is not to propagate the Milan method, but rather to plead for the extensive and proper preparation of a session, especially when it is to be planned or carried out together with another colleague. Even if it is not always possible in all situations, implementing this method to expand one’s own competence is recommended for selected sessions. Recommended: A self-experiment The effect of such questions can also be tested on oneself, by applying them to an important area of one’s own life. For example, one can hold such a session in
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one’s own family or workteam. It is our experience that being on the receiving end of such questions creates a certain stress level that is neither completely pleasant nor unpleasant. As a rule, one is wide awake, attentive and interested. When questioned, one has to think for a moment since the questions are indeed not everyday ones. There are no standard answers available for one’s reply. If others in the family/team are queried, one usually listens very attentively and is surprised to hear them describe something one experienced directly and yet would portray differently. One oscillates between being curious and interested in the discoveries – and a certain embarrassment and the fear that one’s own “games” and those of others will be revealed mercilessly. One notices how irritating it can be to have to – listen how others describe how everyone behaved during some event; – notice how foreseeable and ingrained one’s interactions and behavioral mechanisms truly are; – realize how caught up we all are in the things we are experiencing. Such an interview means walking a fine line between pleasure and pain. The desire to discover new things makes one stick to it, even if it sometimes is rather awkward. 5.4 Comments
5.4 Comments Every experience has its verbal representation. That is why the words we choose to address our clients’ descriptions of their situation and problems is such an important aspect of any systemic intervention. Our comments work on several levels to provide clients with meaning and evaluation. They can also invite clients to assume new perspectives or provide impulses for change. We should not judge our comments based on their truth or falsehood, but rather on their utility for effecting change. Manfred Prior (2012) collected some of the most important aspects of verbalization: – “In the past” or “To date”: Clients often describe their problems as expansive, long-lasting characteristics of their personality or life: “I can’t stand . . .” or “I’m always so shy . . .” Such descriptions imply firm, inflexible traits that cannot (easily) be changed. We as counselors can “soften” them up a bit – perhaps even completely dissolve them – by attaching them verbally to the past: “Up to now, you couldn’t stand it if . . .” or “In the past, you experienced yourself as shy.” This type of comment implies that change is possible: They can help establish confidence in change. – Similarly, the phrase “not yet” can be inserted into our descriptions of problems. The statement: “I can’t concentrate” is seized and converted into: “You have yet to discover how you can better concentrate on this matter or that.” – “How . . . what . . . which” instead of “whether”: The conjunctive “whether”
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suggests either-or-decisions. “I don’t know whether I can come tomorrow.” In the description of problems, “whether” always reflects a black/white duality: “I don’t know whether I will ever be able to finish my training, whether this counseling will work out.” The conjunctive is best replaced by other question words, which move the statement in a completely different direction: “So you’re wondering how you can get your degree and what you have to do to complete it.” “You’re skeptical about what this therapy can do for you.” – “Rather” and “instead”: Clients often employ negative terms to describe the absence of phenomena, which in turn negates everything that was before. Reacting to this is especially important in the initial stages of progress, since allows us to direct our client’s attention to developing alternative behaviors: “Last week we didn’t fight as often as usual.” “What did you do instead?” – “I wish I weren’t so bashful.” “What would you rather be?” – “Great! Fantastic! Amazing!” or “a bit, sometimes, somewhat”: People often couch their experiences in exaggerated-dramatic or understated-minimizing ways. Sometimes it can be useful to differentiate between these two sorts of descriptions, taking up a client’s expressions in the sense of joining – only to play with them later on. This means mixing in more dramatic language with those who tend toward understatement and toning down comments with persons who tend to exaggerate. In doing to, we can loosen up the clients’ descriptions and point out alternative cognitions.
5.4.1 Normalizing Even the simplest of comments can defuse a situation. For instance, a counselor can begin family therapy by stating, “I often work with families with similar problems.” People often feel so alone with their unique problems. They keep their problems to themselves due to a combination of shame, guilt and fear of being judged. This private inner world can be consumed by the myth that they are the only ones on the planet with their problems. Only they keep making the same dumb mistakes, mistakes that do nothing than make matters worse. Such self-accusations are certainly not an easy starting point for bold and constructive change. If such an inner monolog is firmly anchored and leads to a downward spiral of negative devaluation, it can prevent change entirely. In these cases, normalizing comments can be helpful, i.e., using words that depict the problems at hand as solvable and normal vicissitudes of life. By using normalizing comments we introduce evaluative criteria and create a way for clients to see the description as “normal.” – Family background: “In your family, joy and happiness seems to have been frowned upon. It’s no wonder that you never learned to be happy and instead took a depressive stance toward the world. The task you now have is to learn what your family failed to teach you – and remember, no family can teach everything that is important in life.”
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– Family life-cycle: “The youngest child’s growing up and eventually leaving the nest can be quite a challenge for any family and for some, it turns into a major strain.” – Type of task or challenge: “It’s damn hard to continue to write applications when you’ve been rejected 20 times or more. Many people would rather give up, and most need some support.”
Such comments are types of reframings, more or less. They describe the problem as something that is reasonable, understandable, normal. The adjective “normal,” however, is better not used since it implies a judgment on some level, and in the light of the discussions surrounding the use of labels to classify diagnoses it should be distributed only with great care. The clients, on the other hand, do use the term “normal” quite freely, albeit in self-descriptions or in their thoughts and fears: “Am I normal?” This is an important question for many people and indeed demands an answer. In these cases, therefore, it is ok for the therapist to use the word “normal” to respond to such a question. Normalizing comments also signal that we have the competence to answer the questions at hand (see the performance factors according to Grawe, 1999, especially establishment of trust and experience of competence). In addition, such comments help to remove the self-imposed (internal and external) isolation and point out that many other people are also confronted with such problems. The effect is similar to that found in interest or self-help groups: meeting people with similar problems, failures, and concerns lightens our own load and gives us new energy to continue on. This phenomenon may also be observed in organizational counseling: Sometimes all it takes is an open discussion on what employees will be faced with and how they can deal with it, in order to resolve blockages and provide a new energy kick. But there are exceptions, too – situations in which such comments are not fitting. For example, attacks and violence of all types clearly do not deserve to get the label of “normal.” Normalizing comments should also not be used with clients whose problems have previously not been seen or properly acknowledged by others, if very difficult problems have been brushed aside by the client’s environment, or if clients are in desperate need of affirmation of their situation. Here, normalizing could cause clients to feel like they are not truly being understood or taken seriously.
5.4.2 Paying Compliments and Activating Resources Paying a compliment expresses one’s appreciation and creates a positive atmosphere, inasmuch as the person we are paying the compliment to is aware of and can appreciate it. For clients who are not used to receiving positive feedback, compliments serve as a sort of reinterpretation or reframing since they invite recipients to view their own experiences from a different angle. By focusing on what is going well, we direct attention to the existing strengths and resources and call
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them by name. Resilience research (e.g., Werner & Smith, 2001; Lösel & Bender 2008; Laucht et al., 2000) opened our eyes to how children can develop a relatively positive, healthy look at things despite grave life circumstances (chronic poverty, ghettoization, being raised in a difficult family) – and what particular strengths are prerequisite to their doing so. Together with the results of salutogenesis research (Antonovsky, 1987; see Background Text “Solutions Are Important – And So Are Problems” at the beginning of this chapter) these provide clear proof that in our work with such clients we must concentrate on emphasizing their strengths and increasing their ability to survive. Case example: To a single mother who is “drowning in chaos” (the words of the teacher who initiated the counseling) one could say: “Despite all the difficulties you have with your three children, you’ve done great, providing them with the basics – food, getting them to bed on time and getting up in the morning on time. You worry about each of them individually and try to give them what they need. I can imagine it’s not easy having this much responsibility for three little children.” Case example: We ask the parents of an adolescent who has school problems and major conflicts at home what their son can do well. They shrug their shoulders and say: “Right now, not much.” We request that they try a little harder at pinpointing his strengths. After a while, they mutter something about “computer and soccer,” and further questioning reveals that he does really make an effort in these areas and that he has, in fact, shown considerable perseverance. And that their son also has some friends whom he helps out when asked to. At this juncture, the otherwise rather shy and reticent boy listens up at what they’re saying: He hasn’t heard such things out of his parents’ mouths for quite some time. Such resource questions can defuse a charged situation, open doors for constructive conversations, and build up the self-esteem of both parents and child. The message is: If there are even just a few positive aspects, then all cannot have gone wrong!
When working with difficult change processes, we need to muster all the courage and confidence we can, along with stable self-esteem toward our partners. How else can we take on the risks of change? Part of what we do is to make clients aware of every little particle of successful coping in their lives, especially in moments when they are consumed by their problems or feel surrounded by monster-like adversities. We redirect their gaze toward what has been overcome, toward capabilities that may be slumbering in them, toward the little victories in life. We must develop a radar for existing resources and help our clients to regain this lost territory. Compliments, of course, should not be simple niceties, verbal charity handed out out of friendliness or for strategical reasons. Rather, compliments must refer to what the client is describing or showing and refer to concrete behavior. Platitudes are of little help here. This assumes that the counselor can see both sides of the coin and can properly filter the stream of problem descriptions for that which is worthy of being retained, aspects that are likable, original, unusual. This perspective should not be contained in the summary remarks, but should also become an integral part of the entire counseling process. In modern Western culture with its ever-greater tendency toward critical inspection, a view of the positive aspects can play an important role.
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Compliments are particularly important (or especially inappropriate, depending on who you ask) when we are controlling clients or confronting them with unpleasant information. Many practitioners think they have to be particularly steadfast in such situations, worrying that they might cloud their otherwise clear statements too much by garnishing them with approving remarks. We would like to suggest a different route: It is at such junctures, when we are delivering a hard truth, that compliments and supportive comments can be particularly successful in establishing a good balanced message. They help the other person to save face. And they set up a bridge of communication at a time when every is at risk of crashing down into outright hostility. Case example: “I see how you’re trying to get your life back in order and be good parents. You’re putting a lot of thought into it and want to offer your children a good life. That I can really appreciate. On the other hand, you’ve been sending them to school in the winter cold without proper clothing and you haven’t been providing them with regular warm meals. Your children are in poor health and may become really sick if you don’t watch out. I know you don’t want that, and I’d like to to support you in making some changes. However, I cannot and will not simply sit by and watch things go on the way they are.”
In many circumstances where the counselor visits the client at home or in open inpatient wards, compliments should refer to concrete behavior. It is helpful if counselors are adept at observing others and quickly use any initiative, change or constructive attempt by the client in order to distribute compliments as necessary. Case example: “I noticed that you were listening very attentively to your wife without, as used to be the case, having to justify yourself or mentioning how you thought it really was. I think that’s a very important change.” Case example: “That’s great – you got up, went over to Yvonne and told her in no uncertain terms that she should be quiet for a second and not throw the blocks all around the room while we’re trying to talk. And you noticed that it worked! I think Yvonne understands that better than if you were to call out to her from the sofa to just be quiet. That’s very good. Now, what do you think will happen if you always do that?”
Compliments help you to dock yourself to the more productive sides of a client, to activate those parts and then later introduce new processes of change (even if they are rejected for the time being).
5.4.3 Reframing: Changing Your Reality by Changing Your Description Case example: An Oriental king once had a very unsettling dream: He dreamed that all his teeth fell out, one after the other. Full of worry he called for his dream interpreter, who told the king with great anxiety: “I must pass on the sad news that you will lose all of your relatives, one after another, like the teeth that fell out in your dream.” This made the king very angry, and he threw the man in a dungeon. A second dream interpreter was summoned,
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who listened to the dream and said: “I am pleased to pass on the happy news that you will outlive all of your relatives.” The king was very happy at this announcement and rewarded the man plentifully (source: Oriental Stories as told by Nossrat Peseschkian, personal communication).
Here we see that the same piece of information told from a different perspective can elicit very different reactions. Reframing has a long tradition in literature, theology and mysticism. Today, we need only to pay good attention to political statements to understand how modern reframing works (“spin”). Reframing means attaching a new meaning to something said or experienced, putting it into a new frame and thus providing new ways of seeing or approaching something. The terms “positive reinterpretation” or “positive connotation” mean more or less the same thing. There are many jokes that play with this effect of finding different interpretations or contexts for an event or behavior. Case example: A man from Texas, where everything is – of course – bigger, faster and better, is traveling through Europe to visit the homeland of his family. Upon entering the Black Forest in southern Germany he meets up with a farmer on his farm who is very proud of his few acres of forest, his animals and his pastures. The Texan, himself a farmer, begins to tell his story: “Back at home, on my farm, I get into my Range Rover in the morning, take my trusty shotgun and my family along and we go out for a picnic. We go west, always straight ahead in the same direction. In the evening we stop and rest and the next morning we start off real early and continue traveling west. And sometime in the afternoon, we reach the border of our ranch. See what I mean? That’s Texas, my boy!” The Black Forest farmer nods his head knowingly and says: “Oh, I know what you mean, sir, I once had such a dud of a tractor myself.”
It’s no surprise that reframings are often coupled with humor, which helps to put a certain distance between yourself and the matter at hand – and which gives everything a slightly playful feeling, even very difficult concerns. Besides empathy, reframing demands of the practitioner the ability to view things from without and to change perspectives. With some practice, one can learn to adopt this approach to seeing other, new “frames” for what has been said or seen and presenting them to the clients as viable alternatives. Case example: “I always give my children too much and give in too quickly,” says a mother. The counselor is of the same opinion, but is happy that the client can recognize it herself. She answers on a very different level: “And I’m sure you’d like to find other ways of making it clear to your children how much you love them” (Stindl-Nemec, 2001, p. 93).
Such comments can astound clients since they serve to put a new “spin” on the situation (“You love your children, which is why you let them get away with so many things. But you can also learn to use other ways of showing your love for them that don’t preclude settings limits”) alongside the client’s own words (here: “I somehow can’t set boundaries for my children – I’m such a bad mother!”). The important thing is not the plausibility of the new interpretation, but rather its utility: Does the client understand the comment correctly and feel invited to view things in a new light – and, in the end, to take first steps toward change?
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This is where our values as therapists, as counselors and as educators come into play. If truth is not the obvious objective yardstick for evaluating matters, we must become accountable for the values on which we base our own behavior and our definition of utility. Many systemic authors (e.g., Stindl-Nemec, 2001, p. 93; von Schlippe & Schweitzer, 2007, pp. 180 f.) view reframing as disturbing the “previous view of things.” But we do not think that there can be any disturbance of this nature without implications for values and goals. Reframings always implicitly contain suggestions for the route to be taken, and these become more or less apparent to the clients. Reframing anorexia as the role of an adolescent victim who has attracted the vexations of the entire family (thus exonerating them) conveys the message that the family should find better and healthier ways of dealing with its problems and conflicts. How such a suggestion is received surely depends on the way it is presented and the tone and nonverbal signals projected by the counselor. Every communication is simultaneously a manipulation and an appeal to the recipient (Schulz von Thun, 2010a, 2010b, 2010c). The reframing mentioned in the example above concerning a mother’s tendency to be too lenient directs the mother’s attention to discovering alternative ways of expressing her love for her children. But let us now turn to the nitty-gritty: What contexts, and which circumstances, can we use for reframing? Reframing to express good intentions Behavior is often felt to be the expression of good intentions. To this end, one must discern the client’s needs, wishes and motives and associate them with the disruptive or inappropriate behavior. The case of the lenient mother presented above is a good example. Three further ones are provided below. Case example: To the adolescent who clowns around in class and bothers the others you can say: “You put a lot of energy into clowning around and making your friends laugh. You seem to be very good at it. In the meantime, however . . .” Case example: To the father who yells at his children a lot: “It is important to you that your children have clear boundaries and respect for your authority so they won’t get away with everything. You want to be a good father. At the same time it seems to me that it’s important to you to enjoy your children’s love, and that it hurts you when they withdraw from you. Sometimes you don’t know what else to do but scream at them. What if we were to search for a way for you to set clear boundaries for your children and still retain their love.” Case example: To the very ambitious female manager and mother who demands a lot of herself and sometimes suffers from stress-induced headaches: “It seems that your headaches are pointing to something for which you have no words: You’re signaling that you’re overstressed and need to relax. Whenever you have a headache, this is the only time you can allow yourself to slow your pace and demand help from your husband and children. You go easy on your employees and just let things go for a while. Perhaps we could view your headaches as signals of something else, like signposts.”
Reframings applied to family contexts Behavior can be meaningful and functional within the family context, by maintaining a delicate equilibrium or by protecting other persons.
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Case example: To the oldest daughter of a single mother: “I think you understand how stressed your mother really is, and for that reason you don’t always go to school, in order to be at home and help out in the family. It is very kind of you to be so considerate of your mother.” Case example: To a 30-year-old man who has a diagnosis of recurring schizophrenia and who is living with his parents but is afraid of a nearby stream because it might engulf him. His behavior has become so strange that he repeatedly has to be put in a psychiatric hospital. His parents are caught up in an escalating conflict and keep including him in their quarrels, demanding that he take sides: “You know how bad off your parents are and don’t want to leave them alone, even to the extent of sacrificing your own future: job training, your own apartment, etc. And then you tend to overdo it and it gets to be too much for you, which is understandable. Your organism knows exactly what to do: It tells you that you’re getting too much information and are confronted with too many unsolvable tasks, which causes you to do whatever is necessary to get put in the clinic where you can enjoy a timeout from your family, where no one makes any demands of you, where you can recharge your batteries and prepare again for the difficulties at home.”
Reframings applied to family history Case example: To a woman who has put her two children into foster care because of stress and massive neglect. Her own mother, the children’s grandmother, assumed the foster care in both cases and is now raising them. The mother herself grew up with her own grandmother. Now she is pregnant with her third child and is afraid that she “won’t make it” again, yet she would like to keep the child this time: “In your family, there appears to be a pattern that the children always grow up with their grandmother. Now you’re remaining true to the pattern and are repeating it yourself. You’ve mentioned that your mother sometimes feels guilty that she put you with your grandmother and didn’t take care of you herself. Sometimes I wonder whether you’re trying to tell your own mother that you’re no better than she was so she doesn’t feel so bad. Imagine how she would feel if she had been able to raise her three children properly. You are a very loyal daughter: ‘Mama, I can’t make it either, now you can take care of my children.’” The client nods rather disconcertedly: “Do you think that she’s done her duty by raising the two children or should she also have to raise the third one? What if you’ve now been loyal enough and could make your mother proud of you by raising the third child on your own. Why don’t we invite your mother to join us so that we can talk about how she can best help you.”
Reframings applied to someone’s life In some phases of life, flashy, mysterious or strange behavior can fulfill an important function, while at other times it appears inappropriate and disturbing or arouses fear and shame. Case example: To the abused woman who repeatedly relapses into a “dull speechlessness, incapable of a clear thought” and thinks she’s failed all around: “I have the impression that whenever something touches you, you recede into your cocoon. You call that ‘speechlessness’ and it bothers you and you are ashamed. At the same time, that is the only thing that allowed you to survive: Whenever he grabbed you, the only way out was to turn off all your feelings and all your thoughts and pull back to your own inner world, far far away. How else could you have gotten through what happened to you? So what is now bothering you is a very important and smart reaction by your body – to protect its own life. Your body is
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very hurt and careful and says: ‘Better safe than sorry. I’d rather retreat once too often without a good reason than be hurt again.’ The question is how you can slowly learn to tell your body when things are OK, that it doesn’t have to react that way all the time, and that you can now take good care of yourself.” Case example: To a woman diagnosed with psychosis who after many stays on an inpatient ward is now in the assisted-living home of a social-psychiatric institution: She already has a number of attempts at psychotherapy behind her, some of which lasted longer, some of which she quickly broke off. In the first phase, she rejects the offers of the social worker vehemently and abusively, only to later apologize profusely for repelling someone who wants to help her. Her explanation is that her disorder causes such reactions. The social worker reframes her behavior: “You know, I’m not so sure whether your disorder has all that much to do with it. I offered you what I offer everyone: an open ear. But you probably have had so many sessions with so many therapists, doctors, caretakers or whatever, maybe you’re just fed up with all that. It doesn’t seem to have helped that much either, does it? Let’s just forget about the therapy for a while and let me see how I can help you get adjusted into a daily routine. If you want to talk to me about something then just let me know.” The client was thus reassured that the offers she accepted within in the first 6 months pertained solely to everyday matters. With time, however, her trust grew and conversations about other matters became possible.
Competences in disruptive behavior A behavior that is disruptive in one situation may be a valuable resource in another. Case example: To an adolescent who continually provokes his teachers, picks fights with them and bears the brunt of their disciplinary actions: “I’m fascinated by the courage you have to throw yourself into the battle again and again. You are apparently not afraid of danger. You’re capable of doing things I, and many others, would be wary of. And you’re quick-witted, unerring in your remarks. You always figure out very quickly how you can provoke others so that they flip out. It’s only too bad that you can’t use your abilities better, that they always get you into trouble. Imagine what you could do with your intelligence, your instincts, your courage, your openness to risk, your quick wit, your willingness to take a punch or two! I can name off the top of my head at least 20 people I wish were more like you.”
Symptom as metaphor Cloé Madanes (2002) developed the idea that symptoms and problems can be seen on a symbolic level as metaphors. Symptoms can represent the needs and impulses of other family members. Case example: To a mother whose daughter runs away in order to express the implicit needs of her mother: “I think your daughter is sending out an important signal when she runs away, namely, that something in your life together is so difficult that she prefers to flee it. Many families find it difficult to attack such problems. They think the situation is so hopeless and so difficult, or they find some other good reason to simply look away. Only when things get really bad do they decide to do something about it. It’s like going to the dentist: Most people only go when a tooth really hurts.” Case example: An adolescent girl attacks her defenseless mother, while the father stands by and doesn’t react: “You’d like to give your daughter all the freedoms she demands and many others things as well because you love her. But all children have the inclination to
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test the limits and to push the envelope wherever possible. That is their prerogative, of course. But by going so far beyond reason, your daughter is, in effect, telling you that she is desperate to find some sort of footing, some sort of limit. She’s searching for something in you to fight back. And I believe she’s looking for such strength of character because she really does want to respect you. She’s been challenging you tremendously. And I think it’s time you stood up to this challenge.” Case example: A very achievement-oriented family has four teenage and young adult sons, the youngest of whom (12 years old) wets the bed. The family history reveals that the bedwetting began with a setback in the father’s career. The father failed to discuss the emotional ramifications thereof (shame, guilt, feelings of failure) with the rest of the family. The symptom is a metaphor for the father’s hidden issues and the many regressive desires that are not being discussed in the family: “Now, since the question of a physical origin has been cleared up and the temporal connection is so obvious, please allow me to speculate in this direction: You are all very intelligent and quickwitted, I sometimes can’t keep up. Sven is a very sensitive child, and maybe he notices more than others in the family that aside from all the intellectual enthusiasm, the quickwittedness, the joy of being good at something, there is an aspect that is being neglected. He demonstrates this by wetting the bed. Sometimes it is said that the bladder is ‘crying’ too. (At this the mother is wet-eyed, the father looks away in consternation, the older brothers look skeptical, even hostile.) You seem to be doing OK, so do you have any idea what might be coming up short?” A conversation now ensues about how difficult it can be to always be “on top” of things, to always keep up such a high level. The family plays with this metaphor: that it’s sometimes nice just to let things go, to give in to the desire for care, warmth and help.
Reframing does not mean, as it did in the early days of family therapy, that the therapist team reinterprets everything from behind a two-way mirror, supplying the family with a “magic spell” in the hopes that important autopoietic reorganization will then occur on its own. The many descriptions of such reinterpretations found in the literature of that day evoked the notion of a sort of magical touch and led to extreme pressure or even self-doubt among the therapists who felt like losers when nothing of the sort occurred to them. In the various therapeutic settings that abound in social and psychosocial work, the most important thing is to slowly and steadily introduce alternative ways of looking at a problem. This can be done by mere hinting, with humor, through passionate appeals, sometimes with delicacy, sometimes with complete exaggeration. All of which can take time, time to secure the contact with the clients, to reduce or add to, adapt or reject previous approaches. The way this is presented to the clients depends on the situation, the client and the type of contact: This is called “joining.” Here are some variations. – “Maybe we could try, just for the fun of it, to look at the whole matter from a different vantage point.” – “Not too long ago I was involved with a family that had a similar problem. With them it turned out that . . . although I’m not sure whether that fits your situation.” – “A crazy idea just occurred to me, you’ll probably think I’m smad and get up and run away at the notion, but hey, can I try it out on you?” “You know we psychologists (social workers . . .), we’re a crazy bunch.”
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Reframings are meant to dislodge clients and practitioners from their rigid behavioral patterns and ways of explaining that behavior and to invite them to put a more playful or creative spin on things. That’s why a measure of humor, a wink, a histrionic edge serve as good ingredients to make reframings actually work. And last but not least: The best reframings are often those that clients themselves have imagined, that they have at some point thrown out and are then taken up and reinforced by the counselor. The following five steps have proved useful when practicing this method, getting one’s frame of mind adjusted to such a procedure and becoming proficient at it. It has proved wise to go through these five steps together with other colleagues. If you are very determined and courageous, you can use them in your own practice. The five steps of reframing 1. What is it that is so disruptive? Describe this behavior as concretely as possible but without evaluating it. 2. Under what circumstances does this behavior occur? Where and in which situations was it once meaningful or could still possibly be meaningful? 3. What skills are displayed in this behavior? What must the client do to display these skills? How could the client apply these skills in a different or more meaningful way? 4. What does the client want to achieve with the behavior, both on a conscious and an unconscious level? What is the positive goal inherent in this behavior? 5. Which alternative behaviors could lead the client to the same goal? What could the client learn by doing so?
5.4.4 Ambivalent Comments (Paradoxical Intention) Paradoxical prescriptions or comments are often described in professional circles (less so in formal publications, rather in informal settings) as follows: “If all else fails, then use paradoxical intention” – as though this method were some sort of magic bullet to cure all reluctant or resistant client systems (which at least theoretically are not foreseen in systemic thought). In any case, it shows little respect for the client and the counselor. In our experience, paradoxical comments arising from such a sentiment are not very effective and may in fact endanger rather than further cooperation. For this reason, we prefer the term “working with ambivalence.” When confronted by a contradictory constellation containing desires for change and for nonchange, the counselor runs the danger of seeing only the mandate of change and disregarding that of perseverance. This can lead to a breach in the help system: The counselor takes up the cause of change and pursues this goal, whereas the clients come down on the side of nonchange – which presents
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Background Text: On Paradoxical Mandates and Paradoxical Interventions Two very contradictory tendencies are often observed simultaneously in a client system: the desire to change and the hope that everything will stay just the way it is. This is then framed as a paradoxical mandate. “Help us to change.” And: “We’d like everything to stay as it is!” The mandate not to change things is usually only implicitly present when counseling begins and is not expressed explicitly. Sometimes one can “feel” it, however, when working with the client. The situation for the helper is indeed paradoxical: He or she should strive for change while at the same time ensuring that nothing changes. In their volume “Paradox and Antiparadox” (2013), Selvini Palazzoli and her colleagues in Milan dealt with this phenomenon and developed methods of helping counselors react to such a paradox. Their solution was that the helper should not come down on the side of change, but rather also respect the system’s desire for nonchange. In this way, one delivers the message that nonchange is equally legitimate and acceptable. The helper confronts the system with a new paradox, an antiparadox, so to speak. He, too, delivers conflicting messages: Case example: “I’m sitting here with you in order to change things. That is my job, and that’s the reason you came to me.” And simultaneously: “I would recommend your not changing anything, keep all your problems, symptoms, and difficulties just as they are for a while. Changing things now would be dangerous.”
This is effectively the mirroring of the paradox the client system has presented to the helper. The Milan group developed this so-called “paradoxical intervention,” according to which nonchange – the retention of all symptoms and problems – is prescribed or at least suggested, in order to escape from the “paradox trap” that occurs when counselors take up the position of change and clients think up ever more elaborate ways of convincing themselves and the counselor that change is not possible. Developing such an antiparadox would seem to be an easy matter: Suggest to the clients that they should just retain their problems and symptoms. But that’s not the way it works. The Milan group assumed that one should first understand the rules that regulate a client system and only then adapt the paradoxical intervention to these rules. The rules of a system are, for example, the basic tendency not to change, persisting in not moving, keeping one’s inner balance as a way of preserving one’s existing life pattern. Whatever is wrong, whatever problems and symptoms exist, they are all part of the present state of homeostasis, since all states of being and all processes within a system, including all symptoms and problems, together form the entity and mutually determine each other. If you change one element, then that has repercussions for many other aspects and processes within the system.
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For example, a symptom may be a meaningful form of dealing with earlier situations that have, in fact, enabled survival and the continued functioning of the system. As helpers and agents of change, we must still respect the fact that symptoms, however dysfunctional they may appear, cannot simply be eradicated without consequences for the entity. The basic idea of the persistence of symptoms and of their utility as well as the inherent dangers posed to equilibrium when symptoms are quickly excised was not discovered by systemic theory. In earlier psychoanalysis, this was described as the so-called “secondary gain” of illness, which refers to any advantages that may arise for the sick person by way of the symptoms (e.g., special consideration and attention by others, absence of demands). And in behavioral therapy, factors supporting the retention of a problem are diagnosed and included in the therapy plan. We decided to use the term “ambivalent comments” instead of paradoxical intervention because we think this term better emphasizes the fact that the system oscillates between change and nonchange, going back and forth at will. It reminds us of a teeter-totter that needs to be held in equilibrium. This is advantageous when the helper takes up the part of persistence and nonchange and allows the system to swing to the side of change. Gunther Schmidt (2010, p. 129) uses the term “ambivalence coaching” to describe such situations. The terms paradox and antiparadox suggest that only the cognitive side – the playing with contradictions and opposites – and the technical nature thereof are important. That ignores the fact that such situations are deeply anchored in unconscious ambivalence about whether change is “worth it,” whether one should really even make the attempt – or whether even greater dangers and losses lurk around the corner of change. Nevertheless, these ideas played an important role in the history of systemic thought, as they provided a better understanding of the processes that go on between client systems and helpers.
as resistance. Or the counselor presumes that the system is not really motivated and in fact cannot move beyond its present standstill. The therapy falters, the counselor becomes frustrated, there seems to be no progress or benefit from the endeavor. We can skirt this danger by properly acknowledging the ambivalence present in the system and by recognizing the significance of nonchange. This assumes that, first of all, we are aware of the meaning of nonchange for the system and have indeed accepted it as such. It is important that we experience the two contradictory sides as equally “valid.” Otherwise, applying ambivalence is nothing more than a cheap trick that may irritate more than it helps. Truly appreciating both change and nonchange also means being able to accept and communicate
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the system’s decision not to change, which in turn means discussing any and all negative consequences of such a decision (e.g., sanctions brought on by authorities or even legal consequences) with the clients in a open and honest manner and giving them the responsibility for choosing which side they prefer. Case example: In a addiction-counseling center a counselor had spent much time persuading an alcohol-addicted man to participate in an inpatient program. First, he had calmly, later with increasing irritation, listened while the client gave ever more reasons why it wouldn’t work out in this clinic or that clinic. But the counselor kept up the pressure, pleading for participation. Following a supervision session he changed his strategy and admitted to the client that the previous course of counseling showed that the timing was apparently not right for attacking the problem. He said he felt the reason lay in the man’s decision to remain true to his alcohol consumption even if it meant losing his family and his job. This risk as well as the advantages of his continuing to drink were discussed in great detail. The man repeatedly assured him, however, that he really did want to quit drinking. The counselor expressed his doubts, withdrew from the active role and limited himself to asking exactly how the man wanted to go about doing that – repeatedly throwing in that he was skeptical that the client would be able to achieve that goal at the moment. The background of this strategy was the rivalry between the counselor and the client – the object of discussion during supervision – which the counselor now modified by letting the client prove in many small steps that the counselor was wrong. And, indeed, he eventually began to take concrete steps, garnering both the support of the counselor and his continued skeptical comments. This may sound paradoxical, but change became possible only because the counselor had gone through his own painful and drawn-out process of letting go of his preferred strategy: He had to agree to let the client decide against the counselor’s best knowledge by continuing to drink. And he had to convey convincingly that he would respect the client’s possible decision. Case example: Here, the client was a working mother of three nearly grown children who suffered from extreme depression. During the sessions she recounted several different events and biographical reasons for her symptoms, to which she remained true by only coming to counseling sporadically. In the course of therapy, she revealed her very high expectations of herself both professionally and as a mother. She had repeatedly failed to demand help from both her husband and her children, and tended to maneuver herself into situations that taxed her considerably – to which she reacted with depression. Only then would the other family members pitch in and help her out. After a few futile attempts to move her to reduce her expectations and demand more of her family, the counselor excused himself for having put her under even more pressure by demanding so much of her. He told her how much he admired her for resisting his suggestions. Perhaps, he remarked, this could be the beginning of her refusing to follow every demand made of her. As for her family, well, maybe they just weren’t ready to change so radically. Maybe it would be better for her to just stay depressed for a while to elicit their help. Maybe that was the language both she and the rest of her family best understood. The woman reacted with anger to this suggestion and assumed the counselor was terminating his offer of help, which the counselor denied was the case. Rather, he said, it was a matter of finding the right moment. Nevertheless, she went away angry and annoyed and spent the next four days in deep depression and got into a major conflict with her children about their attitude at home. Later, however, out of her anger and vexation she developed a direct and demanding way of addressing her family, so that overall the demands and her depressive reactions lessened.
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In accordance with Boeckhorst (1988, pp. 24 ff.) we can make out four perspectives from which problems can be viewed as expedient. Besides the other aspects mentioned in the chapter on reframing, they can be helpful for ambivalence comments: – Problems can be important ways to try out solutions to other problems; – Problems can sometimes have a protective function by stabilizing difficult relationships that detract our attention from problematic themes or interrupt the course of conflicts; – Symptoms can increase power and influence (“My depression and I can do things together that I would never have accomplished alone.”) – Symptoms can point metaphorically to other important problems in the system. If they disappear too quickly, we may miss their message before it can properly be assessed. Ambivalence comments curb the desire for change. We can suggest to our clients that they first just think about the projected solution, incorporate it into their dreams, instead of implementing it too quickly. We propose that they retain their difficulties, symptoms, problems or whatever for the time being. Or that they simply take the time to contemplate what is to be changed. The advantages of the current situation as well as the disadvantages and dangers of change are pondered or even brought into greater focus. Of course, all of this should occur, with great respect. It has proved effective to recall Prior’s (2012) suggestion that such comments always have a timestamp on them, and that change should always be depicted as an option: “It would seem that, at the moment, you are still very dependent on the help of your symptom, and that it would be too early right now to change anything.” Ambivalent interventions acknowledge the ambivalent (or sometimes polyvalent) forces present within the system and slow down movement and change. They acknowledge the motives that lie behind the symptom as meaningful, dignified reasons, while at the same time emphasizing the responsibility of the client and the need to come to a decision. Clearly, we are not propagating a dose of wonderworking or some special leverage for untangling a counseling knot. If such methods are effective, it is only because the counselor learns to extract him- or herself from unproductive games of circling around the theme of change/nonchange and thus puts a monkey wrench in the system that cries for help to change and at the same time circumvents such advice. An ambivalence intervention actually increases the pressure to make a decision and therefore often causes true movement. Nevertheless, this method should be employed only after careful consideration. Such comments can effectively strengthen the avoidance tendencies in some people with little motivation to change, or when the desire to change in the respective system is weak. It can even lead to the counseling being abruptly aborted and thus all chance for change being lost.
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Case example: A woman living with her children and a very dominating husband is unhappy that her husband has come to counseling only after putting up great resistance. He is very much set against counseling, which is difficult for any counselor to deal with. Using an ambivalence comment during the first session might cause a backfire with such clients and would be of little help to the woman: Her husband will certainly not be persuaded to come a second time (“See what I mean, the counselor also thinks that everything should stay the same.”)
In such cases it may be better to take care of the husband, to push more for conversations and change since the husband will not necessarily already be aware of how much he can profit from a change. Such “wooing” is necessary and often a prerequisite in settings in which one or more clients have been more or less coerced to even come to the initial session. The same is true for other forms of helping, such as in family-help centers where such “motivational phases” can last for many months. Practice has often shown that – despite initial resistance – perseverance in such situations can pay off in the end with good therapeutic results. Similarly, this method can be used with very anxious children who need to be encouraged and perhaps even pushed toward trying out and venturing new things. These are only some of the many examples where other, more direct and directive methods can lead to success. 5.5 Witnessing
5.5 Witnessing Witnessing (coined by Williams, 1997, personal communication) means including additional perspectives in the process, especially perspectives and vantage points that are of importance to the inner process of the persons involved. This includes messages, evaluations or perspectives culled from the people in one’s own life history or life context, or inner voices and opinions that represent parts of one’s personality or “inner authorities.” This concept is similar to the ideas of the “inner team” propagated especially by Gunther Schmidt, which he developed from a combination of hypnotherapy and systemic approaches (Schmidt, 2010, pp. 194, 279; see also Schulz von Thun, 2010a, 2010b, 2010c), and the approaches of the inner “stimulators” and scripts taken from transactional analysis (Steiner, 2009). These various opinions or voices can be attached to persons or figures called “witnesses.” They represent all the possible life approaches, ideas and philosophies. Working with them increases personal creativity and inventiveness and allows the clients to introduce relevant persons or values into the discussion of a particular topic. This is not limited to living or real people; rather, witnesses can be persons from the past, figures from novels or fairy tales, movie stars, heroes, saints – whatever moves you. The only limits are those of one’s own imagination. We first describe the general approach and then present a few examples.
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– The counselor develops a hypothesis implying that working with “outside” views would further the therapeutic framework. – Either someone is present in the stories of the client system who can deliver these outside perspectives – or the counselor asks directly who could contribute something relevant. The counselor can also suggest a particular person from whom important impulses may be expected. This person can then be chosen as the “witness.” – The members of the client system are asked to assume the role of the witness and to be interviewed by the counselor about events that went on within the system. – A counselor who deems it meaningful to qualify (or who outright doubts) the importance or claim of this description can ask the witness how such a view arose in the life of that witness and why it turned out to be so important to judge events according to this principle.
When considering witnessing as tool, the most crucial question is whether a new perspective will help the client system make progress, while the choice of this type of intervention can be prompted by a wide variety of initial hypotheses. The examples given are organized according to the initial hypothesis of the counselor.
5.5.1 Expanding the Perspective of the Client System It can sometimes be helpful for clients to take on the point of view of other persons in their environment in order to gain a new perspective on different ways of describing their reality. This provides them with the chance to get away from a solely internal view and use external resources to their own advantage. Case example: Above we had the example of the 16-year-old pregnant girl Catherine (Chapter 5.2.1), who had to decide whether or not to have her child. Catherine’s decision was caught up in the midst of many different opinions that served to influence her one way or the other. It would seem that the main focus would be on deciding “What do I want?” but sometimes that perspective can actually obstruct the decision-making process. Figuring out what others around us want can be very important at first. In Catherine’s case, it shows her the multitude of various approaches and can make it clear to her where her opinion is located in the sea of opinions. Also, it can further her insight into how one can generally approach such decisions, and that there are indeed many different possible ways of looking at things. Of course, in the end Catherine will have to make and live with her decision. But the presence of various different perspectives can provide her with good and sober guidance. If Catherine were to assume the different witness roles, she could experience how the world looks from the perspective of others, how they view the decision – and she could be queried in that role as to why the respective witness would come to that opinion based on that person’s own biography. All of which qualifies her own perspective. It may be a sensible way to act or react, but not necessarily for everyone. In the background text we describe this process as “deconstruction.”
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Clients sometimes tend to give their own perspectives too much weight. Often one is better capable of acting when having “walked 100 steps in the moccasins of another” (an Indian saying). This is true for families, but also for teams. Case example: Family S. consists of the father, mother, Johanna (14 years old), and Marcus (10 years old). The school has sent the family to counseling because of Johanna’s behavior: She doesn’t listen to the teachers and displays more than the usual provocative and sexualizing behavior in school, dressing and acting like someone from the punk scene. Her teacher is upset about this, the parents apparently less so. They make it clear that they themselves do not think highly of good, bourgeois behavior and attitudes. On the other hand, they do have their differences with their daughter, who is very difficult to get along with and is getting out of their control. Nevertheless, they are ambivalent about whether they really want things to change. The counselor suggests they name a series of positive character witnesses of Johanna from recent years, whereupon they mention two earlier teachers, one of her grandmothers, a grandfather, an old friend of Johanna’s, some of her present friends and her mother’s best (girl)friend. They are interviewed one after the other: An empty chair is put in the middle of a circle, and the counselor asks questions of the respective witness: “Should we be worried about Johanna?” “If so, in what way?” “When did you begin to worry about her?” “What could the family do differently?” “What has been good about her development?” “What are her strengths?” Whichever family member thinks he or she knows the answer to the question sits down in the chair and answers, beginning with “I think . . .” It is acceptable if several family members provide their respective answers to a single question. The “witnessing” from several different positive angles helps the family to look at the matter in question from a more relaxed vantage point without being defensive or worrying all the time. Finally, the family sets up a ranking order of the witnesses on a scale ranging from “I’m not worried about Johanna at all” to “Johanna is in acute danger – it may even be too late!” The witnesses are symbolized by objects, and the family members take up their respective positions among the witnesses on the above-mentioned scale. Case example: In the course of a radical revision of the concept of a team entitled “Flexible Response”9 The team meets after a year’s time to discuss how things are going. The team members all want to recount their own experiences during the past year. The counselor has the feeling that it would be good for the team to add some relevant external opinions when judging the situation and evaluating the changes that have taken place over the course of the year. To this end, the counselor asks the team to say who were the most important partners, helpers and influential others in this period. A number of suggestions are made: clients, members of the institutional management, the local social services division of the two sections of the city, the head of Youth Services, the head of all social services in the city, other teams and providers in the city with similar services. For all of these actors chairs are placed around the team and labeled as such. Anyone from the team who has an idea what the witness would have to say about the past year takes a seat on that chair and reports 9 This team works with youths who live alone in a supervised living arrangement. It provides counseling services on an individual basis and supports the families with offers of family care. After 6 weeks’ time (exploratory phase) the team meets to consider the working hypotheses and goals for the individual cases, which are then presented to the respective contracting institution. There are two further subteams that are responsible for the two major parts of the city.
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from a first-person perspective. The counselor at times inquires about uncertain items. In this manner a very clear picture emerges for both the team and the counselor about what the partners think – what they like, what they dislike and what they failed to notice at all.
5.5.2 Inner Authorities, Role Models and Critics How we approach various life situations depends greatly on our assumptions about what is good or bad, how one should live, what it means to be a good father, mother, son or boss – or a systemic counselor. This concerns the ethical questions in life, the values that determine our decisions and our lifestyle. The notions that reign within a system about how best to do something can be explored quite efficiently using witnesses and thus laid open to be viewed by all involved. Often these notions are helpful in discerning what we think is proper, but sometimes they can actually block both our own solutions and those of others. And occasionally, in problematic situations, they can even be the source of great stress since they demand something of us that we cannot fulfill or does not fit us. Such views are generally connected to specific persons, be they real persons from our past or present, such as parents, teachers, mentors, trainers, friends, role models or leaders who have impressed us; be they ideas, figures from novels, filmstars or visionaries we have read about and whom we have put on a pedestal. In this way they accompany us for a while in life, whether as negative or positive influences. Case example: We recall the example mentioned in the previous section of 16-year-old Catherine who mentioned especially her late grandmother and a teacher as inner authorities who were also powerful inner critics when she didn’t act or decide as they wanted or felt proper. That is why is so important that she deal with their views – just as it is important to qualify the perspectives of these witnesses against the background of the whole story and the witnesses’ respective viewpoints. But for Catherine, having to deal with her grandmother and her grandmother’s opinions and feelings of guilt toward her own children made her own path in life more clear. Case example: A female participant in a training group for systemic theory says that she is having difficulty implementing what she has learned. When she works with families and other systems, she has plenty of ideas, but somehow she can’t use them properly: She just doesn’t feel good enough. After the many encouragements of her colleagues fail to help her, the group leader asks what exactly happens in her head when she has an idea but fails to put it into action in a clear and self-confident manner. She reports a number of very different trains of thought. She is then invited to give expression to her various thoughts from various positions in the room and to associate them with specific persons. Then the group has joint meeting: Minuchin suggests to her that she convince the parents to finally show some authority and assume their roles as parents. Steve de Shazer, on the other hand, thinks that is completely wrong and suggests looking for solutions within the family constellation. Her father is also present and reminds her that she comes from a modest family and should not be so presumptuous as to tell others how they should live. Above all, she shouldn’t imagine being able to help others with such difficult and complicated matters. A former professor of hers joins in and thinks she should see the whole thing as a sociopolitical problem and
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rejects her attempts to individualize and depoliticize the situation. Behind the professor stand her partner and other former fellow students who worked together with her in a political group. All of these witnesses are played by other group members according to the descriptions and positions she gives them. The members of the circle just described are very soon caught up in internal discussions and hotly debates the situation among themselves. Now she can lean back, rather amused at the whole sight, and reports that such a debate seems typical for the pluralism inherent in such situations. It’s good for her to view things from the outside for once. This lightens her mood considerably and frees her from her burden. And above all, she begins to notice which opinions correspond to her own and which do not. Case example: A small religious group, consisting of a parish team that lives together according to the rules of Saint Francis of Assisi, wants to receive coaching because of concerns about the parish leadership, practical matters of living together and the best way to realize their original ideals in everyday life. During the coaching sessions, it turns out to be valuable to let their saint voice his opinions directly on all matters at hand. Each member of the team stands behind the saint’s chair and announces in the first-person what he would have replied to the particular question. Since everyone present (except for the counselor) is well aware of the life and doings of the saint, it quickly becomes clear how great the distance is between what the saint preaches and what he practiced – and how important it is to see these levels when contemplating his answers. The discussion grows ever less dogmatic, and the authority of the saint reveals itself in very pragmatic ways and in pragmatic answers.
Some clients, however, look for answers in places other than counseling. There may have been previous counselors at work, or they have consulted the one of the many available psychological self-help books. These, too, can assume the role of witnesses if they play an authoritative role in the client’s lives. Case example: “What would the author of the volume you’re now reading, ‘A Long and Happy Life,’ have recommended for you to do? Assume the role of the author for a while and comment on your own life situation from that vantage point.” “What would the Indian guru of the meditation teacher you are so fond of have to say about the problem? Take on his role for a moment and I’ll ask the guru a couple of questions.” Let the highest authority of the client, whoever that may be, speak his mind. That is usually a more sensual and more effective experience. Your best bet would be to let a number of such witnesses make a testimony, a method used in courts the world over. Case example: In couples therapy one could say to the wife: “I would like to include in our conversation the therapist treating your husband in the clinic, whom he holds in high esteem.” Toward the husband: “Could you please assume for a couple of minutes the role of your therapist in the clinic?” And to the wife: “And then we should also invite someone from your life who is very important to you, a person you highly respect. Who could that be? Could you please assume that role yourself, so that I can then talk to the two most important people in your lives concerning the problem at hand.”
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5.5.3 Sympathetic Companions Important witnesses need not necessarily be internal authorities. Sometimes it is helpful to invite companions, who are actual witnesses of the system’s actions. Particularly sympathetic companions that have experienced and can describe successful behavior shown by the client system are welcome as “cheerleaders” (see Chapter 5.11.2 below). Here, too, we ask the members of the system to assume the respective roles of the witnesses so that we can query them. Case example: In couples therapy: “You said that last Sunday the two of you were able to successfully go on a picnic. Could your mutual friend Karen perhaps say some more about that? About how you managed to do it and why she thinks it worked out so well? The two of you can alternately take her role on this chair. Whoever comes up with an answer Karen might give can take a seat there and answer as she would.” Case example: During coaching: “Last week a number of things went well at work for you. Who of your colleagues was there to witness them and can he or she tell us a little more about what happened?” – “I would like to ask your colleague a couple of things in order to get a better idea of what happened and how you did it. Could you please assume the role of your colleague?”
5.5.4 Cultural Perspectives in Intercultural Counseling Working with people from other cultures sometimes brings us to the limits of our possibilities. We sense that belief systems and ethical values – what is right and what is wrong, how things are done or never should be done – take on an important role in the counseling setting. And yet we don’t know exactly what our client system’s the culture demands or rejects. Such counseling takes place between the two cultures, so to speak. This can be the confrontation of two cultures that differ greatly, such as the Western and Islamic cultures, or instances when our mainstream culture is faced with a certain subculture (e.g., if the counselor is a middle-class city-dweller trying to talk to a punk, or a family from traditional rural structures or a representatives of the bourgeois upper class). Here, too, we cannot always be sure what cultural principles are valid for our client. Case example: How should I raise my adolescent son/daughter? How much freedom and independence should I allow? How far should my sense of responsibility for my sick parents go? Should I get a job? Which sort of job would be appropriate? How does a good husband act in such a situation nowadays? A modern woman? What makes someone a good father? A good mother? How much do you have to adapt to hold onto your job? How big of a role should work play in my life? When is it just too much? How much should I invest in my family?
The answers to these questions demand not only individual solutions, but also culturally adapted ones. In intercultural interactions one can work with witnesses as a way of introducing such components – even if we counselors do not know
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these witnesses. We should, however, have a good deal of interest and curiosity about them. Case example: A family from Morocco is trying to deal with their 15-year-old son, who has repeatedly failed to come home at night, been caught after various typically juvenile delinquencies and been thrown out of school. It quickly becomes clear that Western child-rearing standards are irrelevant in such a situation. At the same time, the traditional Moroccan cultural standards are just as unacceptable. So what exactly are the Moroccan ideas about what a good father or mother does with such a child in such a situation? During the session a number of very competent persons from the family environment emerge as witnesses: – The mother’s grandfather, who still lives in Morocco; – The father’s father, who also lives in Morocco, but has left the country home to live in
the city; – The father’s brother, who is slightly older and lives in Belgium; – A nephew, the son of the father’s brother – a “good” boy, whom everyone in the family
is proud of and who wants to become an engineer. The counselor asks the family to play the roles of these witnesses in order to discover together what they would suggest doing. The witnesses are first asked about some specifics, such as their age, then what they would do with such a son, what would be most successful and what would not, how a good father/mother should behave in such a situation, etc. The father and the mother then discuss which of the many positions best fits their own thoughts. Case example: In the case of an Italian family whose daughter requested that Youth Services take custody of her because she felt her family was being unreasonably strict with her, there are clearly cultural factors at work. The parents cannot understand how the German authorities can react as they did, taking the daughter’s complaints so seriously. They are certain they have done everything right to make a good and honorable young woman out of her. What to do? Should they go to court to get her back or cooperate with Youth Services, which is requesting that they sign the papers allowing the girl live in a supervised accommodation? What does the rest of family in Italy, France and Germany think about what should be done? What do the older family members and the youngest members of the second generation think (that is, the children of the immigrant family, who were born in the guest country or socialized there for the most part)? Whose opinion do the parents respect the most?
And what do others from the girl’s peer group think – is it better to begin vocational training somewhere or just leave school and wing it? Maybe take a timeout and just wait a while? Whose opinion in the peer group carries the most weight and what does that person suggest? In the examples given above a number of witnesses were queried. This procedure is advisable because people living in migration can be very uncertain both about their original cultural practices as well as those of their new homeland. One can also view this collection of opinions as a sort of scale, for example, with the one end standing for the rural Moroccan approach of some 30 years ago and the other end for that of the modern, successful second-generation immigrants in Western society. We also recommend offering several different models of way of interacting with the new culture. This is especially important when working with the younger generations of
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immigrants who are trying to find their own way between the two cultures. Often the family or circle of friends has at least a few adolescents who have tried out different paths to maneuver their way through the cultural currents and who can be invited as “witnesses.” At the other end of the scale lies the “pure” culture of the old country – usually grandparents, village elders, clan chiefs or religious leaders – who can also serve as “witnesses.” It can be of particular value to identify those members of the extended family who possess a certain ethical authority.10 Families often have someone in their midst who is viewed by the others as reliable and competent. If you do what he or she considers correct, you will be successful both in your own eyes and in those of the family. If, however, you decide differently, then it is more difficult to defend your actions within the familial sphere. It is often easier for migrants to find the proper solution to their problems once they have had the chance of hearing, and exploring for themselves, the opinion of the family authority figure, regardless of whether they adhere to it or not in the end. If possible, and if the client system agrees to it, the family authority figure can be invited to a therapy session. Background Text: Studying, Creating and Deconstructing Constructions In their role as witnesses, clients sometimes provide descriptions of themselves. They relate their own situation from a different perspective, depending on the respective witness. This creates a multitude of different descriptions of the same situation. These various versions of the same reality are placed side-by-side in therapy (on constructions, see the Background Text on the idea of system in Chapter 2). Indeed, that is a central idea behind working with witnesses. Aside from the previously held, dominant version of things, one gets a variety of alternative narratives. Remember: It was the previous gridlocked interpretation that led to the dearth of solutions. Through this intervention, the power and exclusivity of the old narrative are constrained in favor of more diversity that will hopefully create not only new vantage points, but also new opportunities for action. Our advice once again is therefore to work with several witnesses, encouraging clients to “invite” the more unusual ones who have experienced and can describe the situation from a fresh perspective. Another way in which this method can provide impetus for change is it makes the tales of the “internal authorities” tangible. In our own biogra-
10 Andreas Fryszer learned this from Don Giovanni de Florian, the long-time Italian missionary from Frankfurt, who liked to discuss such questions first-hand with large families. It was his observation that eventually most family members would stop talking during such discussions, and the last person to keep up the conversation was usually the main authority in ethical and cultural matters – the conciliaris of the family. If the deciders then did what that person had suggested, they remained on the family’s good side.
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phies, imitation and identification are important sources of discovering and learning new things. We internalize our master – persons whom we imitate or identify with – as well as their views and sometimes their very words. These persons’ thoughts eventually become our own. For clients it can be helpful to experience how their own thoughts go back to being those of the original source. The process is turned on its head: The internalized view becomes externalized. The downside to internalized views of earlier masters, idols and models is that they can turn into inner critics who make negative comments about our actions and thoughts whenever we fail to live up to their standards. They are great at steering us in a certain, rigid direction. This means they are, in fact, no longer a source of support, but rather a considerable burden – or at the very least constant source of irritation. For this reason, we think it is best to strip away a bit of the claim to universal validity these internalized views tend to have. We do so by working together with the client system at understanding these views in the respective context of the biography and thought patterns of the original master (the “witness”). For witness testimonies, the oft-repeated statement of Maturana and Varela is still true: Everything is said by an observer . This reduces and qualifies the general validity of this construction: It is deconstructed. “Deconstruction,” as Goolishan defined it, “means disassembling the assumptions behind the interpretation of the original meaning system and challenging the interpretation system to the extent that all suppositions on which the model is based become clear for everyone to see. And while they are being exposed, space is created for other, alternative explanations” (Anderson and Goolishan, quoted after de Shazer, 1994, p. 70). That is exactly what we are doing when we use the descriptions provided by witnesses to get at their background, their views, their assumptions and their biography. Previous constructions that only led to dead-ends lose their power. A similar line of thought is conveyed in the Buddhist saying: “If you meet Buddha on the road, kill him.” Of course, not every inner authority needs to be disposed of immediately. The important part is discovering the various inner authorities, dealing with them and evaluating their statements in order to allow new paths and actions to arise. Situations discussed during counseling always exist within a certain culture and social context. Sometimes we tend to ignore this point and see things too individually or too psychologically. This is true limited to work with foreigners, but it is there that it becomes most apparent. By working with witnesses we learn to appreciate the impact cultural demands have on everyday life and can use that knowledge in counseling. Certainly, the cultural dimension carries more weight in our work with people from more traditional cultures than in counseling people from Western, postmodern societies. Lévi-Strauss (1966, 2012) pointed out the dif-
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ferences between cultures and spoke of “hot” and “cold” cultures: The “hot” culture, in his opinion, is a more traditional one that takes the fact for granted that children will live as the generations before them have lived – a culture in which life is seen as a circle, where the past and tradition provide orientation for proper behavior. People living in such a culture do not question norms, for that would mean breaking a taboo and stepping outside cultural norms. This is not meant to dramatize the situation, but to point out the practical relevance of, for example, second-generation migrant adolescents becoming outcasts of their own families by not adhering to the traditions of the country of origin. Such family members may be ostracized, leading in some extreme cases to killings or suicides. Our Western culture, on the other hand, is a “cold” culture by LéviStrauss’ terms, because we assume that our children will live a life very different from our own. Life is less of a circle and more of a developmental line leading to the future. Within our culture, there is generally no taboo regarding acting differently than one’s parents. We have the right to define ourselves differently than our tradition had envisaged without extracting ourselves from our native culture. Yet it is important for us, too, to have some sort of orientation – only that most of us have but many systems of orientation at our disposal rather than just a single one. When counseling Westerners, the challenge is to uncover the various orientation possibilities and to work with them. Exploring the values represented by the cultural context of the respective client system – and this is true for all clients regardless of their heritage – is a meaningful step, albeit against very different backgrounds. Working with witnesses can be a very important tool in this regard. A rudimentary form of with witnesses can also found within the technique of circular questioning, when we explore the external view of persons who are not participating in counseling. True work with witnesses, however, is a more direct way of addressing these external descriptions since it moves them into the focal point of counseling and demands a concrete switch of roles – not just a cognitive change of perspective. The result is a much more intense and vivid confrontation with alternative perspectives and narrations than could possibly be achieved through individual circular questions. Also, the next step of working with witnesses, i.e., the deconstruction of these perspectives, is also not possible with circular questioning alone.
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5.6 Modeling Behavior: Behavior-Oriented Interventions The title of this section may sound strange to many systemic counselors. For those equipped with knowledge of second-order cybernetics and the impossibility of instructing a system, it may sound rather heretical to include methods in the systemic toolbox that require the counselor to instruct the clients on what to do or not to do. We plead for expanding the systemic toolbox to contain direct, behavior-oriented and experience-evoking methods. We advocate rehabilitating some of the earlier methods, looking at them in a new light and modifying them by the modern paradigms of systemic theory in order for them to become valuable members of the family of systemic approaches.
Background Text: Helping in Word and Deed: Is That Still Systemic? From the established systemic textbooks it would seem that systemic methodology consists mainly of well-constructed questioning techniques, comments, metaphorical word games, and various forms of sculpturing/formation. The goal of such interventions is to destroy the previous system balance, accompanied (at most) by certain “suggestions” or “invitations” to change – to which the system reacts by autopoietically reorganizing itself (or not). But that was not always the case: Minuchin (2012, p. 106 ff.) spoke rather freely of “restructuring” the family, by which he meant interventions that “challenge a family in the attempt to force a therapeutic change. (. . .) Therapy cannot be performed without joining, but it will not be successful without restructuring.” Haley and Madanes taught their pupils to give instructions. For example, Haley (2007, p. 54 ff.) titled the second chapter of his volume “Giving Directives” and said the main goal of therapy was to “get the clients to behave differently and in this way to achieve different subjective experiences.” With the development of constructivist and narrative approaches in systemic circles, such ideas were forced out of the limelight. Speech, conversation, and dialog came to be seen as the result and catalyst of human reality, and, as a logical consequence, interventions became increasingly focused on verbal descriptions. Yet this was more a process of replacing than complementing systemic methodology. Behavior-oriented interventions sacrificed their libidinous nature, and among systemic experts it was no longer considered proper or state of the art to boast about telling parents in family therapy to set boundaries for their children. It is our impression, however, that this rigid stance has now begun to soften somewhat, initiated by various developments. On the one hand, systemic approaches are being accepted in many different social disciplines. At first, this result-
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ed from an inflated idea of therapy, but lately it may be traced more to the increasing self-confidence of social work in general – which has come to define its own need for systemic approaches. In these disciplines, it is often futile to suggest initiating processes and then stand off with therapeutic abstinence and wait to see what happens. Rather, immediate action is often necessary to assert social norms, and helpers and clients regularly share the same space in daily life (such as on a closed or open ward). Even with helpers who go to their clients there is considerable direct contact to the clients’ daily processes. Experience also shows that a purely verbal approach to therapy fails to rouse many clients. Margarete Hecker and Verena Krähenbühl (from Darmstadt University of Applied Sciences) did pioneering work in the early 1980s and established and explained many systemic methods for social work. Recently, numerous publications have dealt with this theme (Conen, 2011; Herwig-Lempp, 2001, 2002; Hollstein-Brinkmann, 1993; Hollstein-Brinkmann & Staub-Bernasconi, 2005; Hosemann & Geiling, 2005; Ritscher, 2005, 2012). A further influencing factor may be found in concepts for working with very difficult constellations that require very direct interventions. The successes achieved here subsequently caught the attention of the systemic community. Two approaches, in particular, deserve mention: The Dutch researcher Maria Aarts developed a method she called Marte Meo, which has been successful in supporting the development of severely impaired children and has since been transferred to other areas (Aarts, 2009; Hawellek & von Schlippe, 2011). Haim Omer from Israel presented what he called “parental presence” – a very helpful method for families involved in explosive conflicts with their children (Omer & von Schlippe, 2011, 2012). Unrelated to these approaches, Grawe (1999) remarked that continually updating a problem is an effective factor in successful therapeutic methods, a principle that manifests itself in many different therapeutic traditions: Psychoanalytic therapies emphasize that the emotional reliving of one’s inner conflicts can lead to healing; in psychodrama problematic situations are enacted and new solutions are sought through experience; behavioral therapy has numerous methods that put the client directly in the middle of fear-producing situations or encourage the client to try out new behaviors directly. All of the above serves to point out that the chances for success increase if we don’t just talk about problems from a safe distance, but actually try to attack them in an appropriate but direct manner – by detailed descriptions that recreate the emotional participation or by working on the scenes deemed difficult, be it directly or by enactment (see Background Text in Chapter 2.5).
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5.6.1 Personnel: Who Gets Invited? Sometimes our respect for a system’s autopoiesis goes so far that during the initial conversation the counselor leaves it completely to the client system to decide who attends and who doesn’t. In early family therapy there were so-called “convening strategies” – ways of getting as many family members as possible to come to the initial session. Of course, by using circular questioning and empty chairs it is possible to work missing people into the picture, but their physical presence provides many more (and usually better) possibilities. The counselor must therefore consider carefully which persons need to be there and act accordingly. This procedure is clearly not based on what one knows (“Who belongs to the problem system?”), but on assumptions and hypotheses (“It could be advantageous if I were to talk with the parents, the children and the grandparents at once.”). Case example: A mother called because of her bedwetting son (see the case example in Chapter 5.4.3). The counselor requested that the older siblings and the woman’s husband also come to the initial session, which the woman thought strange. First of all, they had nothing to do with the problem at hand, and second, it would be embarrassing for her son to talk about the problem in their presence. The counselor agreed, but stuck by her request, as she thought it helpful to get an impression of the entire family. She had often had the experience that particularly those members of the family who weren’t directly involved with the problem offered the most interesting suggestions for solutions. After a few minutes the mother agreed to this request, and so the whole family came to the first session. It was a very friendly, achievement-oriented family with quick, eloquent communication. This initial impression, together with the fact that the bedwetting had started when the boy entered secondary school, led to the hypothesis that there was some connection between the symptom and the performance demands made of the boy. As if he were expressing the need to slow down, to be taken care of, to relax and let go. Two of his siblings could relate to this framing, which served to exonerate the boy. This hypothesis, which would not have been possible without the presence of all family members at the session, proved to be very useful in the course of therapy. Of course, it was embarrassing to the boy that everyone was there listening, though all had surely been aware of his bedwetting and knew that he felt ashamed. Talking about it in the open and under different circumstances was a great relief to him.
Deciding who to invite is a clear intervention in the client system. It can lead to irritations as well as curiosity. During the initial contact one should respectfully inquire about who belongs to the immediate family, who else is important to the family system, and what the others think about the problem. “Respectfully” means not forcing this on the clients as standard procedure, but garnering the cooperativeness of one’s partner(s). Alternatively, one can get to know the other system members at a later point of the counseling process. Case example: “Have you spoken with your husband about the planned therapy? What does he think about it? And how about your daughter – what does she think about your getting some help?”
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It can be helpful to put the problem, the desires for change, the need for care and responsibility in the foreground and design one’s offer around it, if necessary offering only a limited contract. The message is: Everyone is important. Case example: “So you’ve tried a few things already, and now you really want to make some changes. Well, for that I would need the other family members.” – “Whenever problems occur in one family member, usually everyone is involved.” – “In order to better help you, I’d like to talk to everyone during the first meeting. Sometimes the other family members, though apparently uninvolved, have thought a lot about the problem and have good ideas about what to do to solve it.” – “I can help your child better if I work with both parents. You are both important, you know the situation best, and especially if you see things differently it would be a great help to me to have you both here.”
For those of you who think it might be very demanding to work with large families or systems and thus would rather avoid situations in which everyone is present, here are two valuable pieces of advice: – Take sides: Taking sides induces the fear in everyone else involved of being confronted their own weaknesses. (“Don’t you agree that my husband should be there – he always avoids things.” – “Yes, that is common among men. But of course you’re right – this time he’ll have to come. After all, it’s his son, too, please tell him that.”) – Allude to “deeper” family problems or even marriage problems: “Often there may be other reasons for a child’s problem.”
5.6.2 Initial Encounter: The First Few Minutes How the clients shape the first meeting tells us a lot about the way they are organized and about the patterns present in the client system (see Chapter 2.5; Lorenzer, 1983). It also provides us with many opportunities to intervene and to lay the foundation for working together with the family. There are two generic principles: create an atmosphere emoting stability (establish emotional security and trust, clear up structures and framework, support self-esteem) and identify patterns in the respective system (observation, description of system patterns and processes; see Haken & Schiepek, 2010; Schiepek et al., 2001). An open, appreciative approach enables successful counseling and forms corresponding behavior: – Take time for every individual member and let them speak their mind. The message is: Everyone is important. – The counselor should listen actively, slowing down the conversation, repeating what has been said. This conveys the message that everyone has the right to be understood and to make a valuable contribution. This can revive blocked channels of communication and, in time, strengthen the interactions in the family more pointedly than any other direct attempt could. – Note who sits next to whom and develop hypotheses, always checking them by observing the subsequent interactions.
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– The counselor asks the family members about individual resources and invites them to look at the matter from an alternative viewpoint. This anchors the idea that even people with very major problems can be the competent authors of their own life history.
We discussed this topic at length in Chapter 2 (see the section on Initial Interview). The point we want to make here is that the initial encounter already is an opportunity for intervention, for influence, and paves the way for all future solutions.
5.6.3 Using Vehicles: Working Directly on the Scene When working directly with clients’ behavior we recommend using the problem at hand to modify behavior found within the context of the problem. This can refer to spontaneous scenes observed in the client system, to everyday actions or to concrete tasks that lie at the transition between client and helper system. Carole Gammer (see Chapter 4.4.4) coined the term “vehicles” to describe this intervention: working on a specific theme that metaphorically represents some other system pattern and – like a vehicle – transports messages into the system. That is, we use the work on one area of behavior because, according to our hypotheses about the system, it can induce reorganizational and learning processes for other important system patterns. In hypnotherapy according to Milton Erickson this method is called “utilizing the symptom” and goes back to the conviction that every symptom carries in it the key to the solution. Case example: A single mother comes to counseling with her 5-year-old daughter and her 10-year-old son. The daughter has begun playing with fire and nearly caused a serious fire in the apartment. The situation is particularly difficult because the mother has to leave the children alone in the apartment for a couple of hours every day to go to work. The older brother has assumed the parent-child role. The mother tries to solve the problem by forbidding her daughter from using matches and asking the son to watch out for her. That in turn leads to heated arguments among the siblings. The counselor gives the girl great credit for her being so curious and for trying out new things. During a session she asks the mother to make a fire with the girl on the balcony and to show her how to deal with it. The son watches all this with great impatience, always at the ready to jump in and help out. The counselor speaks to the mother and the boy about what he could do in the meantime and gives him a task: to draw the family as animals, so that they could all talk about it later. The counselor frames this task as something that will help her to better understand the family. The boy agrees, and the mother and daughter have fun making their fire. In the end, everyone agrees on situations in which the daughter would be allowed to experiment with matches (beginning with supervised play with the mother). The son would be relieved of his duty of having to watch out for his sister, particularly with regard to the subject of matches and fire. While the daughter is on the balcony playing with the matches, the counselor talks to the mother about how to give her daughter support, to provide her with the necessary space, and to provide her with gentle guidance. The idea behind this method
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is the counselor’s hypothesis that playing with fire is a symbol for the excessive amount of responsibility being shouldered by the brother as well as a cry for attention from the mother, who has little time left to play with her children. This symbol is used directly to encourage playful behavior in the family and to free the son from his usual parenting role. The counseling session continued with the question of how the family could reserve more time for play and relaxation. Here, and in the discussion of the son’s drawing of the family as animals, the young boy is integrated and his impulses are adapted to other areas.
In counseling situations many spontaneous scenes can be used to offer clients direct coaching, to give them the chance to try out alternative behaviors and to discover what these behaviors feel like in real life. Case example: During counseling sessions we can request that parents instruct their child to play silently in the corner and that they set limits when the child keeps interrupting the conversation. This is especially true when it it is our suspicion that absent or inconsistent rules are part of the problem at hand, in which case working on setting limits can then take up the entire time. We also ask the parents what it is like for them to set such limits. We talk about their worries of upsetting the child, the possible arguments that could ensue between the parents, about their experiences with these new rules. New behavioral patterns experienced and described by the parents as fitting are reinforced by new tasks. Case example: During conflict therapy with a group of adolescents we listen to both groups tell their sides of the story, validate their positions, summarize them, and clarify by asking precise questions. We ask the other youths to do the same. In particular, we ask the “uninvolved” youths to recount their view of things and to help us out. This makes it clear that there is no either-or, but rather a solution that is valid for all. During the negotiations, once the initial steam has been blown, we note which statements were hurtful and which added fuel to the fire – and suggest alternatives. We ask the youths to test these alternatives by saying them out loud. Meanwhile we ask the others to observe the effect of this change of wording. We also ask whether the individual speaking feels his interests are sufficiently represent by this “nonviolent” approach. Case examples: We ask a couple to decide on the topics to be discussed. This process alone can be employed as a vehicle for changing communication patterns. – A mother and her son immediately discuss what time the boy should be home at night, and the counselor can mold their behavior: He suggests that they listen carefully and seriously to what the other one has to say, validate it, and then express their own position, wishes, desires, and limits. He encourages them to negotiate rather than slip into the game of launching mutual accusations.
In many types of helping situations such as socioeducational family assistance (see Buggenthin, 2005), family group therapy (Conen, 2011) or Marte Meo therapy (Aarts, 2009; Bünder, 1998; Bünder et al., 2005; Sirringhaus-Bünder, 2011), the practitioners go to the clients and experience the issues in realtime. They sit in their living rooms, drink their coffee and get a live performance of everyday life. Here it can be helpful to address what is happening while it’s still going on, and to on it right then and there. Case example: Buggenthin (2005) and Girolstein (2005) describe how to coach parents directly to set limits for their adolescent son who has been exhibiting violent behavior
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(toward the parents, too). The counselor works on the parents’ insecurities and provides them with concrete suggestions and support. The counselor takes up the parents’ previous strategies for attacking the problem, points out where these strategies have been successful and have proved useful. If fitting, the counselor also discusses topics from the parents’ family of origin. This validating approach provides new experiences and gives the parents impulses for a number of areas: cooperating in other daily tasks; having the courage to set limits for oneself; experiencing that success sometimes is possible only after a long and hard struggle. Encouragement is provided to overcome defeat and not to give up: Not everything works out at the first go. Case example: In an assisted living institution for the mentally ill some clients have a messiness problem. Working with such clients can mean giving them reasons to clean up tackling the problem hands-on and inviting others in their social network to help out. During this process one can talk about the possible background to this behavior, what the client sacrifices by putting things in order. And one works on the client’s decision of how he wants the living quarters to look in the future. For example, one could tidy up one room and leave another as is and then ask the client to get a feel for these two different rooms. This can serve as preparation for client to make a conscious decision about what life should literally look like in the future, how to “furnish” future existence. This method induces many new thoughts on many different levels: Cleaning up together with the counselor provides situations for modeling and for the helper to understand why the client is so attached to such “junk.” Experiencing the different rooms side by side helps to change one’s perspective and to expand one’s action radius. Doing something together also strengthens the trust between client and counselor, and provides impetus to continue in this direction. Case example: In socioeducational family assistance we can broach the topic of “setting limits,” when we experience how friends, neighbors, relatives, the dog, the chickens or whatever continually interrupt the conversation. We can acknowledge the lively, animated atmosphere and the hospitality and follow by inquiring why the parents choose to live this way. Then we can work out which types of situations are enriched by this open-house feeling – and whether there have been times when the parents themselves have felt that there may be too many visitors, or whether ther children have signaled that it’s too much for them. The next step is to work with them to control such situations. The conversations with the family helper can serve as trial runs for explaining to drop-in guests that they’ve come at a bad time. The family helper can experience the guests’ reactions, and those of the parents, can compliment them on their actions, ask them what was difficult and what was easy, what feelings they had while doing it and then take a closer look at what had happened. (Sometimes people are worried that their friends will reject them or consider them petty or arrogant.) This includes connecting their emotional reactions to earlier experiences and inviting them to learn from them: “Back then you needed to be liked and could not set limits. So let’s take a new look at whether that is still the case today – whether your friends will indeed withdraw from you or whether they’ll simply adjust. How can we go about finding that out?” Case example: In the Marte Meo approach, short videos of everyday events are used to provide parents with personal coaching in order to register their children’s actions and to take constructive steps to deal with them. Such coaching is directed toward teaching parents to read, understand and confirm nonverbal signals – and, above all, to provide validation. Parents are supported in providing their children with guidance, orientation and security, one step at a time. To the extent that the training is successful in encouraging new parent-
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child interactions, new perspective and feelings of competence arise through behavioral modification. This effect is particularly valuable in work with children with developmental disorders or tremendous behavioral problems. Anyone who has seen the videos of Maria Aarts (EFTA Congress in Berlin, 2004) or Annegret Sirringhaus-Bünder and Peter Bünder (EFTA Congress 2004, DGSF Congress in Oldenburg, 2005) has experienced quite impressively how these behavioral inputs create room for mutual joy and happiness in previously stressed relationships. These interventions strengthen fragile relationships, and let love flow again between the individuals. This approach has also proved fruitful in other contexts, for example, when working with residents with severe dementia in nursing homes. Case example: An example of both vehicle development and joining, i.e., the temporary coupling of the counselor and the client system, was provided by Maria Aarts during a seminar (2005, personal communication). She related a contract she had received to carry out a communication training with a group of socially incompetent male adolescents. The adolescents’ motivation was not completely clear or indeed always present. Maria Aarts took the time to informally come into contact with them. While smoking a cigarette in the cafeteria they chatted about number of different topics, and Maria Aarts learned that the main issue of interest in their lives was how to get a girlfriend and how to keep her. She suggested training them in exactly this skill: How do I win over a girl? And how can I keep her as my girlfriend? She then proceeded to train basic communication skills using this “vehicle”: picking up on and pursuing the interests of the other person; listening, asking questions, showing interest; expressing one’s own feelings, showing displeasure in such a way that the other person can relate to the feeling; sharing joy with another person, etc. This method had the side effect of improving their overall communication skills for use in other situations, increasing their self-worth and confidence, and making way for alternative means of coping with difficult encounters.
This aspect of the Marte Meo training – acknowledging and labeling the initiatives of children – can also be implemented in counseling families with small children, who react intensely to changes in the overall family atmosphere. Case example: During family counseling the discussion turned to the burden and sadness of the father’s losses. He showed little emotional response, which was also an issue in the relationship between him and his wife and their children and had been addressed before. In the father’s family of origin, sadness and other feelings had been strictly taboo. In counseling, a pattern became apparent: When the situation became emotional and the father was showing clear signs of being moved (flushed face, watery eyes, body position), his 2-year-old daughter would go over to him with her stuffed animal in hand and ask him to pet it. We used these signals by pointing out to the father how clearly the daughter was registering his feelings and how much she wanted to console him. He was able to accept her physical attempts at giving consolation, but refused any words of comfort. Still – it got him thinking. He began to share more emotions through his behavior and was increasingly better able to verbalize and share them with his wife. Had these short scenes not taken place – had we not invited the 2-year-old to attend the session – everything would have been considerably more complicated and tedious, and perhaps some aspects never would have been discovered.
Any systemic counselor knows that interventions can only work if they fit the clients’ values, wishes and goals – if they tie in with their behavioral patterns and
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address relevant matters in their lives. What we discussed above can be coupled with further exploration of resources, with questions about exceptions and possible future solutions (miracle question, etc.). If we know what the clients can do or used to do and what they dream of doing, we can perhaps come up with better suggestions for modeling their behavior. In this way, we introduce suggestions into the system which the clients would not have come up with on their own. Constructivistic humility, of course, has taught us that in the end clients themselves decide what is fitting and what is successful. That can also mean sacrificing an idea, even if it has been successful in numerous other situations.
5.6.4 Changing Spatial Constellations – Working with Limits As we have already described in the chapter on sculpturing above, the seating arrangement – the spatial constellation – can symbolize relationships. This, then, is not a symbolization induced by the counselor, but rather something we might call a “spontaneous sculpture.” Case example: The 3-year-old little girl clings desperately to her mother. The father sits apart, near the door, seemingly uninvolved but tense. The 15-year-old son has turned his chair around and is sitting on it like a knight on his horse. The 11-year-old daughter studies the rock collection in the dish on a small cabinet in the room. The mother yells at her son to sit up “straight.” The father glances at his watch nervously. The mother attacks the father. The daughter complains of stomach pains (which was the reason the family was there).
Why shouldn’t we view this as a sculpture, as a choreography of relationships, and work with it? The first five minutes of the session have delivered so many impressions that can serve as material for hypotheses. Especially Minuchin (2012, p. 174 ff.) and Minuchin and Fishman (1981, p. 189 ff.) suggested working with spatial constellations and seating arrangements in order to break up habitual interaction patterns and introduce new information into the system. Case example (continued from above): The therapist emphasizes that everyone was clearly somewhat nervous and tense at the beginning of this family therapy. He had (through resource-oriented joining) determined that the 15-year-old, besides the normal grouchiness of puberty, had many positive sides, for example, that he liked to play with his 3-year-old sister. The therapist asks him how he thinks his sister is doing and how one could help her to relax. After a short conversation on this topic, the therapist pays the boy a big compliment about how much he can empathize with his little sister and asks him to sit down at a small table with her so that she can do some drawing and relax. The boy agrees, and the therapist now changes the scene by discussing the stomach pains with the 11-year-old daughter and her parents. He notices that she’s always peering at her siblings out of the corner of her eye. He asks her how strong the pain is right now, on a scale from 1 to 10. She answers with “6.” He then asks her to go over to her siblings, to play with them or read a book. After talking to the parents for 5 minutes he asks her again how the stomach pains are doing. She now says “3.” The parents look at each other full of guilt and ask whether it has something to do with them. This remark is removed from the guilt context and put in the
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help context: “I see you’re wondering whether you’re responsible for your daughter’s stomach pains. However, it is my observation that everyone in the family is very attuned to his or her feelings and clearly notes what is going on around them. Everyone expresses this differently – by clinging to the mother, by having stomach pains, by blocking everyone out and being grouchy. Imagine if someone were here who could translate everyone’s expressions – what would he say this all means?” The boy in the corner calls out: “Too much trouble!” The mother says: “It’s all too much for me.” For the remainder of the session we talk about stress in the family. The two older children are now back in the circle, and the 3-year-old continues to draw at her table. Toward the end of the session the therapist emphasizes how clearly the 3-year-old can expresses herself: When the family talks about its problems without raising their voices, she can get on with her play without worry.
By changing the seating arrangement and the spatial constellation, we catapult certain topics to the frontlines and work with them in the sense of “challenging the habitual behavior” (Minuchin & Fishman, 1981, p. 190) or, put differently, we have unsettled things. The change created through this modification leads to changed experiences and changed behavior. Playing with these aspects implicitly invites the actors to take on a playful-experimental attitude toward their own problems and behavior patterns. Such a method has a better chance of succeeding if the counselor does not remain dead serious, but introduces it with humor and a certain facility: Case example: “Hey, I’ve got a crazy idea. I warned you I sometimes have crazy ideas, so now’s your last chance to leave! No one wants to go? OK, let’s give it a try.”
Similar to the way circular questions lead to toying with ideas and possibilities, this method can lead clients to play with various constellations and thus increase their choices. And similar to our work with sculptures, this approach addresses several different dimensions of experience: cognitive, affective, kinesthetic, actional. Playing with limits (a classic from Minuchin, 2012) The counselor asks the parents to sit down next to each other and takes the child out of the position between them. She can seat children next to herself and ask them to observe how their mother and father discuss an issue. Or the counselor can ask a child sitting next to her to give her a nudge when a topic comes up that was not supposed to be discussed. She can ask parents to observe how siblings negotiate a dispute. She can invite a father and his son to sit off to the side and observe how the mother and sister plan an excursion. She can ask the children to go to a room next door for 20 minutes while she talks to the parents about a certain topic. She can leave the room herself and give the clients a task. – All of these interventions demonstrate how the counselor changes the setting and plays with the limits: between the parents and children, between men and women, between generations. This enables new experiences, and the counselor learns from the participants’ reactions about their ability to change and where the system is headed. Nearness-distance regulation From research on nonverbal behavior we have learned much about how people regulate their personal territory and what stress reactions are shown when these
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limits are violated. This more or less unconscious regulation of behavior plays a major role in conversations: Changing the seating arrangement alone (distance, angle, placement in room: is someone sitting with their “back against the wall,” is the “escape route” cut off, etc.) changes both inner states and behavioral patterns. This often comes as a surprise to clients. For many clients this game takes on another, completely different meaning: The invitation to take care of oneself first (“Take your time, try to find out where and how you would like to sit, where you feel best”). For many, that is unusual and can strengthen their self-esteem and mindfulness. Case example: In the nonverbal behavioral patterns the counselor registers a clear uneasiness in the air during a dispute between two adolescent girls. One clearly wants to approach the other, but the other squirms, remains silent, turns away. So the counselor asks both of them to place their chairs in away that “somehow seems right” to them. The two girls shift their chairs back and forth – one wants to come closer, the other wants more distance. After about 5 minutes they finally find a position acceptable to both. To their surprise, the rest of the conversation is much more relaxed.
Body position, breathing, movement, gestures When dealing with matters of contention, one can observe these physical characteristics and invite clients to make small adjustments. Is someone sitting on the edge of their chair, how fast is their breathing, do their gestures seem menacing? One can suggest that the parties carry out their dispute while standing or while taking a walk, whatever works best for them. Case example: During the counseling of a mother and her 20-year-old adopted daughter it becomes clear that major conflicts tend to be approached with great fear and caution and are expressed in terms of moral accusations, particularly by the mother toward the daughter. Following such censures, the daughter slumps down in her chair, looks at the floor, her breathing is shallow, she look uncomfortable. Both are sitting facing the counselor. At the beginning of the second session, he asks them to sit directly opposite each other. During the conversation he uses a technique known from psychodrama (doubling), whereby the counselor stands next to the clients and – with their consent – formulates what he has heard in their statements. In doing so he pushes the conversation away from the moral questions and toward the underlying anger. Mother: “I think you’re just so unthankful. I’m so disappointed that you never come home in time for dinner.” Therapist: “For me it sounds like – and correct me here if I’m wrong: ‘It makes me mad when you say you’re coming home for dinner and then you show up an hour late. I look forward to it, go through all that work, get everything ready, and then I just sit around and wait for you. I don’t like that.’” More and more, the mother concedes that “sometimes she does get a little bit angry about it.” The daughter sits up at these rephrasings, the conversation gains new momentum. When the mother’s states that she’s been addressing issues the wrong way and that she wants to learn how to do it right, the therapist says, it’s not his role to show her what’s right or wrong, he’s only repeating the undertones he hears in her voice.
Symbolization of people absent The method used in circular questioning to represent absent system members (“What would X say if he were here?”) can be supported by using symbolic repre-
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sentation. Empty chairs can be set up to represent people not present at the session. This creates an almost playful atmosphere (“pretending as if”), which can be used in many different ways. While setting up the chairs one can ask: “Where would they want to sit, would they feel comfortable being here?” In certain situations, we can ask those present what they would like to ask those absent or what they would say to them. We create a whole new level of experience by asking them to speak to the empty chair and imagine that a person was sitting there. The effect becomes even stronger if stuffed animals are used to symbolize absent persons. Especially younger children are amenable to acting out these playful-metaphorical games. Setting limits This can be very direct and sometimes desperately needed. When working with clients who have a tendency toward violent behavior, we often observe situations that demand strict spatial limitations. Case example: A trainee working as a social educational worker describes a conversation in a family. The problem was that the mother always presented herself as weak and helpless, and that her 12-year-old son kept on threatening her and sometimes even hit her – even when the social worker was present! When he became frustrated at something his mother had said he started hitting her. The social worker intervened and put an end to the matter with physical force: She stepped between the mother and the son and grabbed the son, holding him back. That was quite risky but worked, since she had known the boy for a while and had developed a good relationship with him. She sent him to his room and then spoke with the two separately and then, again, with both at once. The mother viewed this as a valuable model. But a more important aspect of the experience was that her son could in fact “survive” having limits set and that, afterward, he was calmer and more friendly. Throughout the rest of the counseling they often discussed which of the counselor’s actions the mother could adopt.
5.6.5 Presenting the Situation: Staging and Enactment These methods are well-known from psychodrama (Fryszer, 2005, 2006). The clients are asked to depict a particular situation. Everyday scenes, but even more so the main conflict situation itself, are relatively easy to enact with those involved. When working with families, one can usually count on children four years and older to show considerable interest in this method – unlike other more verbose approaches. Any ensuing differences about how a particular scene unfolded as well as differences in how the situation was experienced can provide important stimuli for complementing one’s own views. Case example: Family A. consists of the mother, the father, the daughter Claudia (4 years old) and the son Peter (7 years old). They have come to counseling because the parents are worried about Peter, who is very anxious, especially in school, where is afraid of some of the boys in his class. As early as in nursery school he was wary of the wilder, more aggressive boys, but recently he’s been having nightmares and sometimes even refuses to go to school. He wakes up at night and cries out so loud that the whole family wakes up. During the
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first session the counselor asks how such a scene develops during the night and then requests that the family reconstruct the scene in the therapy room. The children’s and parents’ bedrooms including their respective beds are set up using chairs and blankets. The family members lie in their beds and act as if they were sleeping. When Peter cries out, the mother get up from her bed in the parents’ bedroom and runs to his bed in the children’s bedroom. She sits on the edge of his bed and takes Peter in her arms, holding him tightly. Claudia looks on from her bed, the father lies awake in the parents’ bed. In this scene the counselor interviews each participant separately (see below). Claudia is upset that she has to lie alone in her bed while her mother comforts Peter and takes him in her arms. Peter feels comfortable and safe and can no longer remember what he dreamt. In his mother’s arms his fear subsides. On the one hand, Mrs. A. likes holding Peter in her arms and feeling that she is able to comfort him. On the other hand, sometimes it’s just too much for her and she’d like to go back to her own bed. Mr. A. is happy that his wife takes care of Peter, although he’d also like to know what is going on in the bedroom next door: He feels left out of the whole thing. Mr. A. accepts the counselor’s suggestion and does something he doesn’t do in reality: He goes into the children’s bedroom to see what’s going on. While standing in the door and observing his wife and son, Peter throws him a nasty look, and when the father actually enters the room Peter begins to cry out: “No, I don’t want you to come! Go away!” Peter’s voice is clearer, firmer and louder than usual. The father and mother are surprised at this reaction. The father stops in his tracks, uncertain what to do. The counselor interviews the father once again, who expresses his insecurity of whether he should continue and whose feelings of being excluded have now been confirmed. He’d like to be part of the action, but also has the feeling he should pull back. Claudia, asked by the counselor about her feelings, says she likes it that her father has come – he should come over to her bed. At this juncture the scene is stopped. In the ensuing discussion the children are asked what they liked about the scene and what they didn’t like. Peter says he enjoyed being in his mother’s arms and that he liked yelling at his father. Claudia says she was glad her father entered the scene. The subsequent conversation takes place mostly between Mrs. A. and Mr. A. and the counselor. Both parents are surprised, and to a certain extent glad as well, at Peter’s unusual behavior and his sudden change from anxious and whiny to being rather aggressive. During the scene they clearly noticed that Peter is not as weak as he sometimes appears to be, and that he sometimes has a big influence on family life. The father, who must spend days at a time away from home, says that the scene has provided a number of interesting clues to his diffuse feelings of not belonging in this family. Also, his desire to become part of the action has also become clear to him. But he also felt his normal tendency to withdraw in order to avoid doing anything wrong. Claudia’s jealousy was new to both parents. At the end of the session, Mrs. A. is unclear about whether she wants to continue to respond to Peter’s wishes as she used to. Mr. A. decides he should become more involved in the situation between Peter and his wife. It became clear to both the family and the counselor that Peter’s symptom was having a major effect on family life. Both parents were encouraged to deal with the question of how they wanted to shape their roles as mother and father and where they saw a need for change. This prompted a basic willingness in the family to continue working on the matter together – rather than viewing it as Peter’s problem alone. Thus, in the sense of the systemic approach, a major goal of the initial contact had clearly been met.
A counselor’s so-called “aside” interview and the enactment of a possible future scene are intervention techniques taken from psychodrama. During such an inter-
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view, the counselor questions the clients and asks them to speak indirectly, i.e., away from the scene (“aside”), about what they are now feeling but would otherwise keep to themselves. This method helps clients to address the situation, and it also helps the counselor to understand what is going on in the individual actors. It supports open communication by introducing things into the scene which the family members had previously not communicated of their own accord. The moment something has been said as an “aside,” i.e., without looking at the others, it becomes part of the family members’ communication. This method enables the individual family members to gain a better understanding of their feelings, needs, points of view with regard to the experience and the way these differ from those of the other members of the family. The “aside” interview described in this case example led the counselor to employ a further method from psychodrama, namely, the enactment of a fictitious future scene in which a family member tries out something new. Here, the father gives in to his need to come to the others in the children’s bedroom and to see what’s going on. Such a method is especially fruitful when working with families, as it gives them the chance to explore how the others would experience it and react when one actor behaves differently than usual. A further application lies in anticipating major future changes and their potential effects on family life, for example, when a child moves out or when a new child is about to be born into the family. This method can sometimes help the family to better evaluate situations and to make the right decision, say, whether a child should be put in a foster home or boarding school. Sometimes family members need to develop new approaches to their roles and try them out in a dry run, so to speak. Imagining and enacting drastic changes in the family can often bring clarity with regard to the family’s resources and limits before the actual event has even happened. If the entire system is present, then such testing of future events can be very realistic. Through the enactment of these future scenes, the counselor helps the family to seek solutions oriented toward the future and to experiment with the possible consequences in a playful fashion. This approach requires careful preparation, and must be fitted to the system in question – it should not demand too much of them (“I’m not a good actor”). In our experience most clients, even if at first they are rather reserved toward doing such enactments, eventually warm to the technique of monologs and aside interviews. Depending on the situation, the counselor can suggest different levels of intensity and participation. Case example: The counselor asks the clients to help her better understand what they have described. She requests that they all stand up and enact the situation. This is not role-playing as such, but rather a depiction of the spatial context. The clients work while standing, and perhaps they can depict other elements as well by taking up different positions in the room (“Dad is sitting on the sofa, and next to him are his two sons, they’re watching television. And now, what happens when Mom enters the room and says dinner is ready – where does she stand when she says this? Oh, I see, back here . . .”). The counselor lets the actors play the scene as it more or less happened (“And how exactly did the argument go: When you said ‘Say it now.’” – “OK, thank you, and what did you answer?”).
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If one wants to weaken the interaction patterns that are causing the problems, it can be helpful to carry them to the absurd: The counselor can ask those present to exaggerate a certain behavior and to act it out as such. Or the counselor introduces absurd elements: dramatic gestures, large distances. This presumes that the relationship between the counselor and the clients is good, and that the counselor likes to take risks, be experimental about things and is comfortable with such methods. Acting “as if” introduces an inner distance to what is expressed and makes it all “experimental” and “unreal,” changing the mental perspective of previous interactions. The actors can no longer slide into their usual problem-causing patterns since the interactions that now take place are viewed against an absurd or funny background. Clients often report that, once back home, they revert to their old behavioral patterns and then have to laugh at themselves when they think about the enactment that went very differently during the counseling session. A similar effect can be found in role-change, where clients are asked to assume the role of another person. This, too, is possible only when great trust has already been established, since it presumes that noone will use the situation to demean someone else or showcase how awful that person acts. If properly used, however, this method can help the actors to better understand other roles and see what it feels like to walk in the other’s shoes. This is also an excellent source of empathy training and generally raises clients’ social competence. Such role-playing situations can be used for experimental purposes. New role behavior can be modeled through mutual interaction and then tried out and deepened in a subsequent enactment. Case example: Counselor to client: “What would that look like – him saying what he doesn’t like without insulting you?” To the partner: “Could you please try that out for me?”
We can ask clients to portray such changes during the counseling session in order to compliment them (in the sense of cheerleading, see Chapter 5.11.2). This method can even be employed during individual therapy to induce emotional concentration. Here, we work with empty chairs that symbolize the most important persons in the client’s life. Clients can attempt to attack difficult matters, to express what they previously could not express. An example is the uncensored expression of anger previously held back. The results can be quite surprising: New perspectives turn up; or it can be good to just get it off your chest; or the client discovers (to his or her own surprise) that the problems purported to be causing one’s anger are not as important as previously assumed. One can also try out a number of variations. Sometimes it is more effective to voice things directly rather than talking about them. This triggers emotional-affective processes that may lead to more clarity and, above all, are easier to remember. All of these methods introduce an element of movement, humor or playfulness to our work. They activate creative problem-solving in difficult situations. In the sense of Grawe’s functional factors, these methods have further advantages: They represent powerful tools for updating problems and for raising clients’ emotional
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involvement, which, according to neurobiological research, is an important prerequisite for building new, alternative neural pathways. And they contribute to long-lasting and strong visual and kinesthetic impressions that can serve in everyday life as anchors for possible alternatives. However, all of these methods must be closely adapted to the client system to avoid imposing a foreign element and effecting negative resistance or withdrawal tendencies. In this sense they are more demanding than purely verbal methods since they require constant and careful monitoring of the process on both the nonverbal and physical level. When using these methods, we must avoid giving the impression that we are “teaching” the client something about what is “right.” This may be the trickiest aspect. It is our experience that one can indeed work very effectively with this method, but that well-founded systemic modesty is also necessary. The whole process must be designed in a way that maintains the focus on trying out new things. We must continually ask the clients (and ourselves) whether what we are doing befits them or not. This in turn, as a sort of bonus, reinforces the clients’ self-esteem. 5.7 ModellingCont exts:Net-Work
5.7 Modelling Contexts: Network After a long period of time in which concepts of individual cases and therapeutic approaches to psychosocial work stood at the forefront of interest, social networks have recently witnessed a comeback (Altmeyer & Kröger, 2003; Herwig-Lempp, 2004; Röhle et al., 1998; Zwicker-Pelzer, 2010). It is amazing that such concepts are once again considered “modern.” As far back as when Alice Salomon laid the foundations of social work over 100 years ago, social networks were already deemed necessary “to provide support to humans among themselves” (Zwicker-Pelzer, 2010, p. 366). There is a long tradition in social work of community work, as witnessed by community psychology (Sommer, 1982; Sommer & Ernst, 1988) and by family therapy (Speck & Attneave, 1987). Working with and modeling social contexts is, in our opinion, a basic part of systemic work. In the light of the value of social networks in general, it would contradict our understanding of our own discipline to limit social systems to just families. Of course, this approach is more challenging, demands more know-how, and financial coverage is not always guaranteed. Not all forms of systemic training include work with networks. Nevertheless, including a client’s social network in one’s work can be of great value and expands the realm of the possible solutions immensely. At the 1986 family therapy congress in Brussels, Johan Klefbeck and his colleagues introduced an interesting model of network therapy used in a social hotspot (see Klefbeck, 1998). When individuals or clients were confronted with crises, Klefbeck and his co-workers included the clients’ friends, colleagues, neighbors and other important persons in the counseling process. Sessions were held with groups 20 to 30 persons, in the hopes of activating the resources present in this network to discover solutions. Such a session is prepared by taking stock of the relevant network together with the clients, and preparing a network
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Figure 29: Network map and VIP map
map containing the symbols often used in genograms or family maps. The network map can be divided up into several sectors, and individuals are entered according to how close the clients feel them to be. Relationships are represented by lines and other symbols. This results in a map that can depict the relevant persons beyond the usual (fragile) family system, which in turn provides stressed family members with the hope of establishing contacts in other areas. HerwigLempp (2004) collapsed these and other models into his so-called “VIP map,” which sounds better to most clients. Figure 29 depicts both models side-by-side. Such a map should always be constructed with an eye toward the envisaged goal and benefit: A geological map of Europe is of little use for hiking through the woods. We therefore suggest trying card on yourself first and then using it to answer the following questions. Once all relevant persons have been collected, one can venture the first cautious hypotheses based on this visual impression (see the case example below). The following questions can be important for proper application. They refer to network dimensions that provide important indications of functioning social support both in research and practice (see Sommer & Ernst, 1988): – Content: What are the most important types of social relationships in my life (friendship, collegiality, family)? Under what circumstances are they more or less important? – Density: How many contacts are there in my network? Do I have a few strong connections or many weak ones (or vice versa)? Reliable or unreliable contacts? – Accessibility: How quickly can I reach a network partner? Does anyone live in my immediate vicinity? Could I get them out of bed if I needed someone to talk to? Or do we only meet by chance, every couple of weeks or so? – Compatibility: Does my network offer me support in my present stage of life? Or do I need to approach other networks or build completely new ones? If I am
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a single mother, do I know other mothers with whom I can exchange tips and baby clothes or just have a good talk? If I am in training, do I know anyone else in a similar position? – Reciprocity: Is the relationship balanced, with both sides giving and taking? Or am I just a giver? Or do people withdraw because I demand too much and give too little? – Stability: Can the relationships withstand droughts and crises? Or are they merely fair-weather affairs? Following this thorough inventory one can invite the important persons in the network to help in solving the problem at hand. Case example: Cloé Madanes (personal communication, 1989) reported on a young man who had made several dramatic suicide attempts near the apartment of his earlier girlfriend. A family session showed that the young man was rather isolated: His father was no longer present in his life, though there were two uncles he knew well from childhood. In light of the preceding dramatic events, Cloé Madanes invited them to take a couple of days off from work to help take their nephew’s mind off his negative thoughts and maybe become acquainted with other women. She reported that the three men got along very well, and that the young man was able to establish new contacts and enjoy the support of his uncles, who took over the role of the father he had never really had.
If the counselor can’t or doesn’t want or go this far, perhaps one can work with the clients on the basis of the network map to strengthen specific parts of the social network. Case example: A single mother was sent to counseling by Youth Services because of various problems her daughter was having. She was in a rather ambivalent relationship with the girl’s father. He hit her repeatedly, only to then assure her that he wanted to do better – without concrete results. She was determined to get away from him, came back to him. The daughter had become very confused and disoriented by this roller-coaster ride. The woman took good care of her daughter and was attempting to complete occupational training herself, since she desperately wanted to get off welfare. From what she had reported, it was clear that she had a very week network. Her network map is depicted in Figure 30. Working with this map confirmed the hypothesis that her loneliness and her need for the practical support (driving her to appointments, watching out for the daughter, discussing her meetings with authorities) were preventing her from getting away from her partner. The initial steps in counseling thus consisted of expanding her social network. We used her career aspirations as a framework: If she truly wanted to attend and complete occupational re-training, she needed neighbors who would support her – and support her daughter, who desperately needed more contacts to help her in school. So she activated old friendships, moved to another neighborhood and got in touch with other mothers there. This approach was so successful that in only 6 months she had made the decision to completely sever the relationship to the daughter’s father. She entered a training program, and the problems the girl had had in school got better the more solid the living arrangements became. There were even matters the mother was able to solve on her own – ones the counselor had planned to help her with. Another mother in the neighborhood became her good friend and was a great help in her daughter’s upbringing.
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Figure 30: Network map of a single mother
The map can be drawn up together during a session or alone by the client at home. It is especially valuable when it prompts the client to tell stories, to remember, to think back. The network often does not reveal itself in its entirety until one enters this phase of the counseling process and one story leads to the next. It’s similar to working with sculptures or the family board where symbols represent individuals in the family who can be moved around until they find their proper position. With the network map, too, one must strike a balance between clarity and completeness. 5.8 Externalization
5.8 Externalization By employing externalizing interventions we provide problems or internal processes with a symbolic form. This can occur with words or with actual objects. This method was introduced to family therapy by the Australian researcher Michael White (White & Epston, 1990). Such techniques were developed in hypnotherapy according to Milton Erickson to give form to symptoms or other physical/mental phenomena. A wart is depicted as a dodgy guy who leads the way to important, dormant desires (Lenk, 1988); a stomach ache becomes a hard lump and then a loudspeaker that can express important messages (Prior, 2012, personal communication). In the German-speaking countries many authors used these symbolizations early on, for example when speaking of depression as a visitor whom one invites in and can just as easily ask to leave again (Weber et al., 1987).
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Case example: A classic, often-cited example is the therapy of an encopretic boy described by White (White & Epston, 1990, pp. 60 ff.), who in the course of his conversations with the boy and his family gave his habit of soiling the bed the figure of a “sneaky poo.” Thereafter, the therapy concentrated on determining all the things this monster could do, the times he typically showed up (and the times he didn’t), and what effect he had on the boy’s life and his family. Basically, these are the same questions we used for an exploration or intervention (see Chapter 2.4 and 5.3), the difference being that they are now related to an imaginary being instead of directly to the problem or desired solutions. It became clear, in time, that the “sneaky poo” had the effect of isolating the child from other children and making it difficult for everyone to see the positive and interesting sides to him. It meant stress for his parents and their marriage, and kept the family from inviting friends and neighbors over. It also destroyed the happy moments between the mother and her son, and so forth. But the boy also said that there were times when the monster did not come or was successfully banished. Based on these descriptions, and on the exceptions mentioned, a number of interventions were possible. For one, the counselor was able to work with the family on reining in the negative influence of the monster. How could the mother and son experience good moments despite occasional visits by the monster? How could everyone in the family continue to stay in touch with their friends? It was important that the parents recognized the boy’s strengths and enjoyed having him around. Further, the counselor used the symbolization to figure out what the family and the boy could do to banish the monster from their lives.
In externalizations, we begin with the clients’ descriptions and work with them at finding or creating a symbolic form for the problem. This can also occur in the form of a question: Case example: “If this inner voice were a being – what would it be?” – “If this depression were a human being who always popped up at the worst possible times, what kind of person would that be?”
Such a symbol can have the form of a human being, a mythical or fantasy creature, or some other object. Instead of asking the client, one can also make a suggestion and observe how the client reacts, whether the suggestion is acceptable or not. Case example: “When you speak about the anger that overcomes you again and again, it makes me think of a tiger who’s lashing about with his claws out.” – “The way you describe your daily life reminds me of someone who’s always carrying around a full bag of stones on his back and keeps inviting other people to put more stones in the bag.”
Sometimes it may be better to use questions in advance to invite the client to describe the aspects or scenes in concrete terms. Symbolization can then be embedded more organically into the conversation. Case example: “Your stomach pains, are they more warm or cold, sharp or blunt? What color do they have? Do they feel large or small?” – “So, there is this sharp, cold, red object, this tiny but fierce thing that goes on a rampage in your stomach. If this object were a kind of being, what kind of creature or animal would it be? What comes to your mind as you’re describing it?” Case example: “And this voice that keeps repeating to you: ‘Don’t let them jerk you around, don’t let them rip you off!’ where does it come from, from behind you or from the front?”
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– “Oh, I see, from behind you. This may be a little difficult for you, but it would be helpful to me if you could be more precise – does it come from the left rear or the right rear side? Is the voice male or female, high- or low-pitched? And what does it say, exactly – does it always repeat itself or does it say different things? And if you were to look over your right shoulder right now after hearing that deep male voice and someone were standing there – who would it be? Could you identify his face?”
Some clients need time to get used to such procedures. That is, we sometimes need to overcome resistance and garner the client’s acceptance for such unusual (strange, crazy) questions and statements. It helps if we’ve already established a good and trusting rapport that can withstand such cheekiness and weird ideas. When overcoming such obstacles be sure to stay attuned to what might make it easier for the client. It might help to mention their children and the advantages of baby talk. Or to comment that others benefited from talking about everything in a whole new way. Case example: “I like to use this comparison when talking about the problem since children better understand that. Can you live with that?” – “Recently, in a family with very similar problems, this method had a surprisingly good effect, and it was very helpful to imagine that the depression was an unwanted guest who repeatedly came uninvited.” – “Now I’d like to confront you with a really crazy idea. Let’s assume your bed soiling is a mythical creature that always seems to be bothering you. What do you think it would look like?”
Once a symbolization has been introduced and accepted by the clients, the counselor can proceed in various directions: – Asking about exceptions to the rule and what helps to keep the unwanted guest at bay. – Determining together with the clients what can be considered useful about the monster’s visits. – Working out what helps drive away the monster. – Asking clients to go and find the objects they used for their symbolization and to deal with them for a while. Case example: Based on the advice given by Gunter Schmidt (personal communication, 1991, reprinted in Schmidt, 2010, p. 285 ff.), the counselor suggested to the client to procure a number of bricks and to carry them around with her. She had the habit of weighing herself down with things, shouldering them with great patience, but then sliding into depressive moods. The client found the idea rather strange, but the counselor thought it might be interesting if she experienced her situation very concretely – what it’s like to let others pile so much on your back. He said it was important that she stick it out for the next 3 weeks, until the next session – which she did, reporting that she became very angry with the counselor after about 10 days, because he’d given her such a “stupid task.” She became so angry that once, while in town, she’d taken the bricks and thrown them with vehemence into the next available waste basket. That made her feel lighter, in every sense of the word. During the next session she reported that, in the days following this incident, she had withdrawn from her parents on one occasion, and from from her girlfriends several times, who always were asking her for some favor. Thereafter, the discussion turned to whether this aggressive act (which was untypical of her) might serve as a reminder that she has a right to set limits to others.
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Such a method can also include asking clients to imagine their inner states as real beings, obtaining symbolic figures and talking to them. Case example: While counseling a man who had sought help because of stress symptoms it became clear to the counselor that the man was putting tremendous demands on himself to complete every task perfectly and quickly. But this behavior was also causing him to neglect his family and his hobbies – and himself. He was aware of the fact that this self-made stress was the result of his ambitions, which led him to do everything with 150% commitment and accept help from no one. During the conversation, one particular figure kept popping up to depict his inner motives: a pastor clothed in black, with the name of “better safe than sorry” (his father had been a Protestant cleric). He also found a figure to depict the other side of this coin, called “just chill out”: a little devil figure. The counselor and the client talked a while about the meaning of the Devil as a fallen angel, and the counselor told him a story from a book by Peter Ustinov (The Old Man and Mr. Smith) describing some funny scenes where God and the Devil need each other. Toward the end of the session the client was given the task of buying toy representations of these two figures and talking to them every evening for about 20 minutes and review the events of the day. Maybe they would tell him who had the upper hand on that particular day, and why that was necessary, and how they envisioned the competition between “better safe than sorry” and “just chill out.” Just talking about this task was itself a source of amusement, and during the next session the client reported enjoying the whole thing very much, thinking up scenes in which the devil deceived the pastor. These externalized dialogs were the starting point of two important processes: finding a new balance in life and recalling important scenes from his childhood. Working through these childhood memories also helped him find a healthy level of stress in his life.
Symbols can also be used as reminders of important advances and changes in life, as externalized forms of important goals and intentions, so to speak. Case example: In management coaching, a client reported that it was important to her to demand more of her subordinates and reduce her tendency of giving in to every request brought her way, showing sympathy for the employees’ problems while neglecting her own needs. She chose a stone from the counselor’s collection and put it on her desk. It was both an object of decoration and a very effective reminder for her not to lose track of her own goals.
Background Text: How Do Externalizations Work? Plus: A Warning! Externalizations work in a similar way as reframing: They allow the situation to be seen from another vantage point and create a playful distance between oneself and problems experienced as very serious and difficult. The problem (e.g., burdening oneself too much) receives its own symbolic expression (bricks in one’s pockets). Dealing directly with these symbols (becoming angry at the task and throwing off the load) transitions to doing the same with the real everyday burdens. A difficult and exhausting internal conflict (to chill out or to be perfect at all tasks) takes on a visible form. And even if this new form leads the whole
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situation ad absurdum, it keeps the inner struggle from going on as before: If the client allows himself to become involved with the conflict, the latter is coupled to the externalized game, resulting in amusement and some distance and new perspectives: New approaches to solutions become evident. The playful, humorous nature of this method allows clients to confront themselves with sometimes repressed resources from their childhood and to (re)discover their own playful creativity. All of which is necessary if behavioral patterns are to be changed. The playful nature of this method comes in handy especially in systemic work with children, since they often use symbolic, magical forms of thought to process their experiences. Child therapy with psychodrama consciously employs this method and uses symbols to improve children’s understanding and cooperation. The more negative, shameful sides of symptoms recede into the background, making the whole thing a lot more fun. Furthermore, important unconscious matters can now be expressed, they become present in everyday life and can encourage new decisions. Michael White’s suggestions to find masquerades for symptoms (“sneaky poo”) are in themselves creative contributions to and expansions of the interventional repertoire of systemic therapy. However, they also carry the risk of viewing annoying problems only (or preponderantly) in a negative light: All things bad must be overcome. This can cause us to neglect the fact that such problems may actually be meaningful within their overall context. As described above, however, these aspects can be brought into focus by playing with symbols. 5.9 MetaphorsandStories
5.9 Metaphors and Stories Why people love metaphors and stories, Saadi, a Persian poet, already knows: “Sometimes we can’t avoid science, mathematics and learned discussion, which help us to further develop human consciousness. But sometimes we also need poems, chess and stories, so that our mind can experience joy and refreshment” (quoted after Peseschkian, 2007, p. 9). Background Text: Using Stories in Therapy and Counseling “Stories have always belonged to popular psychotherapy dealing with conflicts, long before psychotherapy became a scientific discipline” (Peseschkian, 2012, p. 17). Stories were, and still are, elements of counseling in all cultures. They help people to see things differently, to accept new solutions to their problems, to adapt to what can’t be changed, to find solace. In this regard, the Oriental storyteller, the griot (traveling musician) of many African societies, the mother or father who tells their child a fairytale, the writer who composes a carefully
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crafted tale – all play a similar role. In psychotherapy, stories and metaphors were quickly adopted as part of the repertoire. We would like to mention a few of the authors who made a substantial contribution to this process and to whom we owe a great debt for providing many impulses. The first is the great Nossrat Peseschkian, who collected Oriental stories for use in psychotherapeutic work (e.g., Peseschkian, 2012, 2007a, 2007b). The second is Milton H. Erickson, who in his own brand of hypnotherapy often reverted to such methods and whose pupils carried on this tradition and laid the foundation for a rich collection of stories and metaphors (Lankton & Lankton, 1989; Trenkle, 2010, 2013; Zeig, 1980). In systemic therapy, narrative approaches (Anderson & Goolishian, 1990, 1992) are best employed with the thought in mind that human systems are, above all, linguistic systems that perpetuate themselves through the repetition of stories and tales. This tradition encourages clients to tell their stories, whereupon the counselor tries to use and rework these stories with questions, comments and reframing. But stories and metaphors can also be introduced when more direct interventions are met with resistance. They address the more unconscious, eidetic processing of information. Peseschkian (2012, pp. 30 f.) speaks of “depot effects”: By stimulating our imagination, stories remain in our memory longer and are more easily retrieved in everyday situations. They go under the radar of clients’ resistance, and clients can adapt and interpret them as best meets their needs. In Peseschkian’s transcultural method they have the role of transporting traditions and conveying information transculturally. People from the Orient have always used stories to lay open the resources of their homeland, to remind themselves of their traditions and values, and to motivate themselves to consciously face the question of which values one wants to maintain in the new home country. People from the West view such stories as a treasure chest of alternative viewpoints and behaviors. Stories can also serve as “regression aids” (Peseschkian, 2012, p. 32). They loosen up the situation, provide contact with childhood behavioral patterns and recall lost resources, encourage creativity and a humorous approach to reality, invite one to fantasize, and provide the necessary space to develop alternative visions and utopias. They ideally complement short-term approaches such as the magical question or imaginations of the future.
We have a wealth of different ways to work with metaphorical elements. For example, we can – choose and adapt stories from the realm of fables, – offer reports on the way earlier interventions went, – tell our own (or slightly adapted) stories and anecdotes about things that have happened elsewhere or in the past, – work with maxims and mottos.
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The following list of action mechanisms and applied uses for metaphors refers expressly to the works of Peseschkian (2012) and Zeig (1980).
5.9.1 Joining: Stories Can Be Useful During the sometimes tense initial session(s) of counseling, stories or anecdotes can help the clients relax and “break the ice.” They create trust and confidence and thus support the overall process of counseling. Case example: To a mother who was ashamed to be coming to counseling at all, but who had tackled many new tasks in her lifetime, we told the following story: “If you want something you’ve never had, you must do something you’ve never done.” From a resources point of view this story is not quite politically correct, since it assumes that the desired goals, at some point in time, already existed or were within reach. But for this woman this little piece of wisdom corresponded quite well with her present situation (never having been to counseling) and her experiences (bold and risky new beginnings). She laughed, then became thoughtful, and was finally able to relax and engage in the conversation that followed. Similar effects often lie in personal anecdotes that fit the client’s personal experiences: When working with fathers who work in the construction business, I (R. S.) sometimes tell them that I myself once worked in road construction. If appropriate, I tell the rather embarrassing little story of how we students once drove the company’s bus into the ditch and one of the regular workers had to bail us out. That can loosen up the atmosphere and carries with it the message that even counselors need a little help from their friends sometimes, and that everyone in the room is in possession of a special set of resources.
5.9.2 Illustrating Stories, Encouraging Insights, Mirroring People who are caught up in their old habits often find it difficult to see the meta-level and to objectively view their own contribution to the conflict. In such situations, stories can help to set up a mirror for them to look into – without being confrontational about it. Clients can always say that the story is nice, but theirs is different. Even if the counselor retreats and agrees, the story is now out in the open and may have a longer shelf life than expected. When dealing with quarrelling couples or other conflictual parties that are trying desperately to win us over as judges or allies, one can tell the following well-known story: Case example: A rabbi is approached by a bickering couple. The husband describes the situation to him. The rabbi nods after some consideration and says: “You’re right!” The man is overjoyed at this news and tells his wife what the rabbi has said to him, whereupon the wife runs to the rabbi full of indignance and tells her side of the story, to which the rabbi says: “You’re right!” Back home, she reports this to her husband, who in turn goes back to the rabbi and angrily says: “Rabbi, you said I was right, and an hour later you tell my wife she’s right – you can’t do that!” To which the rabbi says after some thought: “You’re right!”
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Islamic tradition tells a similar story (Peseschkian, 2012, p. 28). The bafflement at this unusual turn of events causes clients to recognize their own dogmatic position. They are able to assume the metaposition and think about their situation more carefully: What if both of us were in the right, without the counselor having said so. Case example: When coaching managers who make very high demands of both others and themselves and have difficulty delegating things, I (R. S.) often tell the story of a similar coaching situation I experienced many years ago: The head of a clinic was having massive problems with job stress. He was a quick thinker and usually came up with good solutions to problems that cropped up. When the team analyzed the situation, it turned out that this man’s quick wit had in fact led to a sort of passivity on the part of the other managers. One head physician said with a sly grin that during meetings, they had learned to wait after the problem had been presented until the boss had offered his solutions – which came quickly and were “nearly always quite useful.” This pattern of interaction caused the clinic head to assume that the whole responsibility for coming up with solutions lay with him, which of course also matched his idea of leadership.
This story always produces a discussion about one’s own managerial style and the interaction patterns in one’s own team. The good thing about it is that it doesn’t actually describe deficits, but rather the very special talents of the clinic head.
5.9.3 Encouraging a change of perspective Stories, metaphors and jokes have been used for centuries to effect surprising and sometimes eye-opening changes in perspective, something that can then be activated in therapy and counseling as well. Case example: I tell clients who always see themselves as victims and whom I (R. S.) would like to invite to assume more responsibility the following story, which I experienced in my judo training: We were attending a week-long judo workshop with an older Japanese trainer and were in the process of practicing freeing ourselves from handholds on the floor. We were lying in twos on the floor, my partner put me in a grip, a sort of stranglehold, and I was to try to implement the escape trick we had learned – which wasn’t working out at all. I was busy trying to loosen my opponent’s grip around my neck – struggling intensely but with little success – when the trainer stepped up to us and gave me a clout on the head: “If you want to move your partner, move yourself.” Then he went off again to someone else. Japanese trainers are said to consider their knuckles and powerful words to be effective didactic means of getting their message across. In any case – I was lying there, at once upset and rather disoriented when it donned on me that, indeed, I had concentrated solely on the stranglehold (it was a rather tight fit), leaving the rest of my body dangling as if paralyzed. I started to become more active, to change the angle, to get away from my opponent with my legs and lower body, to grasp his legs with mine. The result was that he had to continually refit the hold in order not to lose it. The whole situation took on a new dynamic, and in a moment of carelessness on his part I slipped away.
The saying “If you want something, look for a way; if you don’t want something, look for an excuse” says about the same thing – but is not suited for many clients due to its drastic and confrontative wording.
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Sometimes sayings or little poems can present new approaches: “Detours raise your knowledge of the locality” is a saying from Vietnam that is applicable to clients who complain that their life is not smooth enough. Or: “How to get God to laugh? Make some plans!”
5.9.4 Stories Cause Searching Behavior and Open up Lost Resources Telling stories is, formally speaking, akin to hypnosis: A well-formed story makes the listeners forget about what is going on about them (dissociation). They conjure up intensive images, which, like psychotherapy, trigger inner searching processes that can free one’s own resources and lead to solutions. Case example: During the counseling of an extremely achievement-oriented client, the conversation turned to his relationship with his father. He described his father as a cold and absent man. The only chance of getting any attention lay in performing some special feat. Being the oldest son in the family, he also had the greatest responsibility, so it was understandable why achievement had become such a major part of his life. I (R. S.) told him the story of the young rascal he surely had been and whom he had completely forgotten over the years. This story, which we then worked on together, dealt with what rascals do with their time, the tricks and pranks they think up, etc. After developing this story, I gave him the task of looking for this little rascal in his present world: Every other day he should take about half an hour’s time to read children’s books, think about his childhood, talk to his siblings, whatever seem helpful. In the next session, he reported that he had forgotten the task – he had wanted to call me, but he was too ashamed of himself. Every day he had tried to remember what the task had been. To my question of whether he had done anything interesting during that time, he said that one day, after work, he had spontaneously had a pillow fight with his 4-year-old son. That was not at all like him since he usually spent the evenings working on the renovation of the house. Since that day, however, he and his son had played together regularly and had done a number of idiotic things that were great fun. I congratulated him and said he had solved the task much better than I had originally envisioned it.
5.9.5 Introducing Possible Solutions Indirectly Through Models Stories present us with models. “They depict conflict situations and suggest possible solutions or note the consequences of individual attempts. Thus, they represent a sort of model learning, though the model is not hard and fast, but rather contains any number of possible interpretations and reflections on one’s own situation” (Peseschkian, 2012, p. 29). The last point is of particular importance to us because many stories contain a more or less explicit moral and may therefore be rejected, because they appear to limit choices rather than increasing them. And yet they present an opportunity to delve into possible behavioral alternatives and their consequences: The “depot effect” of such stories can activate certain elements found in various everyday situations much more than if done on a cognitive level. One can avoid presenting stories
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as linear models of moral commandments, by modifying them (put in other contexts, add Oriental or fairy-tale elements) to make them appear as an “offer.” Case example: When dealing with conflicts, the story of the two donkeys has proved useful: The two donkeys are attached to each other and try with all their might to reach two racks of hay located in opposite directions. Since the rope is too short, neither of them reaches its goal. After thinking for a moment, they decide to go fill their stomachs together,first at the one pile and then at the other. This metaphor can be used as food for thought for the next session. Or the counselor uses it immediately by discussing what the rope stands for – What has bound the two antagonists together? – and what situation is mirrored by the futile attempt to reach both goals at the same time. In short, what are the consequences of each donkey striving to reach his goal regardless of the other – and what possible solutions are available to the donkeys in their context? Proposing acceptable solutions means conjuring up reports from previous cases and using them as examples. “A single mother whom I counseled a few years ago proposed a very nifty solution after much pondering . . .” – “Last year I met an adolescent who had a similar problem to solve and got the following solution from a friend of his . . .”
In order for our work with stories and metaphors to remain productive, we need to be mindful of the following five points: 1. Empathy: Clients need reasons Some people learn by observing others, whereas some have to try things out for themselves. Still others can learn solely by thinking about things. The counselor must remember that most clients will find it unusual – and strange – to have stories told during their therapy sessions. It may therefore be advantageous to embed and justify the stories: Case example: “Many people learn best by observing others. In counseling, for example, I find it very rewarding to observe the creative ideas my clients come up with. And many of my clients think it’s helpful to learn about how other people who were in a similar predicament went about things. Something just occurred to me that might address what we’ve been talking about, and I’d like to relate it to you.” Case example: “While sitting here, listening to you, a story just came to my mind. It is one of the Oriental stories collected by Dr. Peseschkian. I like telling stories, and about 60% of my clients really benefit from hearing them. Maybe it will be of some use to you, too.” Case example: “A couple of years ago a family in counseling had similar problems to deal with and came up with some fantastic ideas to solve them. I think it was so fascinating and unusual I’d like to share it with you.” Case example: “That reminds me of a saying that’s rather radical, however; I debated whether to tell you, but it’s been bouncing around in my head for some time now and I’ve learned it’s better to take such ideas seriously.”
2. On constructing a good story: Masking and drama Effective stories should be a good fit to the client’s situation in several respects: context, space, persons involved, time. And yet they must be masked enough to
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avoid any direct connections. Their purpose is to encourage the clients to think about their own situation. Masking can be done by placing the story in a completely different historical or metaphorical context (fairy-tale, other country, other time), or by changing the story to provide sufficient distance (the protagonist is a mother and not a single father, an aunt instead of a meddling grandmother, etc.). The story should, in any case, contain resources that are useful for solving the problem(s) at hand and that have been identified and discussed by the client at some point: That increases the identification effect. But stories must also have a certain innate drama to them. Counselors must practice telling extravagant stories! Build up the suspense, emphasize certain parts, push others to the background, vary your tone, the tempo, the volume of your voice. The best way to practice is to tell stories to children and to learn from that what keeps them glued to your words and what “turns them off.” 3. Qualify: Invite, don’t preach Many stories can be overly pedagogical and preachy (think back to your own childhood). As constructivists, we do not want to do that to our clients. Besides, telling such stories rarely evokes the desired effect or is rejected outright. Even if we resort to telling only ambiguous stories, our clients will presume some pedagogical background and may distrust our motives. But stories need not be preachy. They can just as easily invite us to look at things from another vantage point, to explore alternative paths. If you want your stories to be accepted, qualify them. 4. Don’t discuss “Dirt that we tread isn’t hardened, but spread” is a piece of wisdom that goes back at least to Goethe. As a rule, stories need no explanation and do not need to be interpreted or subsequently discussed. This is the way they release their “depot effect” and set the inner thought processes in motion, eventually leading to creative ideas. For this reason, we stop any need to discuss the story by remarking that we are unsure whether that would be fitting at the moment – and then change the topic. Sometimes it’s helpful to tell stories at the end of the session or to pass them on to clients “for the road.” The story’s effect on the client, however, should be discussed at length. 5. Stories’ effects are not specific If this still seems too pedagogical and “edifying,” here’s a piece of constructivist consolation: When employing stories, we should always count on clients hearing and interpreting them in a completely different way than we had intended. One can never accurately predict how any particular client will react. And that, precisely, is why such methods are so valuable: The solutions that filter down from stories and metaphors always result from the clients’ own associations. Only then do the clients experience these solutions as their own achievements. Case example: A female client came to therapy for treatment of her very intense anxieties. Her parents had instilled in her the conviction that self-assertion was a sure sign of egoism
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and thus “evil.” On her first invoice was a postage stamp bearing the likes of Wilhelm Busch and one of his verses: “What is good, this is true, is the evil we don’t do.” She came to the next session and was now convinced that this stamp had been chosen especially for her. She had spent much time thinking about what it meant, and then it dawned on her that she had to allow herself more of what she had always considered evil. She even tried it out, tried consciously to be “evil” toward others and was pleasantly surprised to discover that she liked it, that she felt free and that the others didn’t automatically shun her. I debated for a long time whether to tell her that the stamp had actually been put on the letter in our office, and that Wilhelm Busch meant what he said in completely the opposite way: He spoke of refraining from doing something, not allowing it to happen. 5.10 BetweenSessions
5.10 Between Sessions One of the most interesting tasks assigned a client was given by Milton Erickson (personal communication of Bernhard Trenkle, 1997). Case example: Erickson had been called to treat an older woman who had fallen into deep depression following the death of her husband. Since he was only going to be in the city for a short time to take part in a seminar, there could only be one consultation. During the conversation he discovered that she had belonged to a church congregation but had stopped attending services on a regular basis. And he discovered in her room that the Alpine cyclamen were blossoming. When he asked her about them, she reported with great pride that it was a very difficult matter to get them to grow, and that this was the only thing that gave her strength since the death of her husband. At the end of the session, Erickson, with all his authority, gave her the following task: She should continue to cultivate these flowers and should go to every christening, confirmation, marriage and funeral of a member of the church and give someone one of her flowers as a gift. The woman followed his advice and soon was once again integrated in her contacts and in the congregation and eventually overcame her depression.
This story shows how tasks can be implemented in systemic counseling. The important thing is usually not the actual task itself (giving away flowers doesn’t sound like a real therapeutic goal), but combining the context and the resources in a particular way gives birth to new experiences. The task described above got the woman in touch with one of her resources (growing Alpine cyclamen) as well as with important people from her church community (her loss of contact was both the result and driving force behind her depression). The assigned task was focused on occasions in which the congregational members would be confronted with similar challenges as the woman: life-changing, in part sad, in part happy transitional events. Its is easy to imagine that, during some of the ensuing contacts, besides the joy at receiving such a rare present, important conversations were struck up about what it is like to lose someone and facing a new phase in life – just as the woman was currently experiencing. Thus, such tasks serve the following purposes: – To strengthen the process of change in the time between sessions, – To attest to the clients the responsibility for changing their own lives,
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– To enable new experiences that can then be worked through in counseling, – To leave certain issues behind and to experiment with new ones (trial runs), – To address important topics metaphorically and thus to work through relevant (but perhaps tabooed) topics indirectly.
These methods are employed in many different sorts of therapy. Especially behavioral therapy has developed a massive arsenal of such “practice” methods that can be assigned to clients between sessions. For example, self-confidence training uses multilevel plans to confront clients with ever more difficult tasks – from asking for directions to going to a shoe store and trying on shoes with a salesperson for an hour without actually buying any. Systemic therapy can learn much from these interventions, although systemic approaches are usually aimed at goals: The goal is not simply to practice some new behavior, but to fulfill the tasks in a way that induces change in the patterns of the relevant client system (see the case example in Chapter 5.10.3 “Change Tasks”). Tasks can be categorized according to various criteria. We suggest a goal-oriented structure that categorizes tasks by function. If applied with caution, one can also adapt this to include a task’s function depending on the client’s willingness to change. Below we list the various types of intervention along with examples. This sort of classification necessarily implies a certain amount of arbitrariness, but for learning and demonstration purposes it is useful, even if any number of mixed forms emerge in practice (Table 13). Table 13: Overview of the different types of tasks Observational tasks
Ambivalence tasks
Change tasks
Rituals
Trying out new things
Clients are requested to write down when the problems occur and to note what happened before and afterward.
Clients are requested to keep up their problematic behavior a little while longer.
Clients are given tasks to trigger the new behavioral and interactional patterns.
Ritualized instructions are developed to respond to important transitional situations or to react in certain critical situations.
Newly developed and desired behavioral patterns are assigned to be tasks that should be tried out for a while or modified.
This allows a differentiated view of things: The context is considered, attention is focused and paths of action usually become clear.
In the presence of high ambivalence toward change, this serves as an invitation to take some time, and shows respect for nonchange as a better alternative.
New experiences become possible, both on the behavioral level and on the level of interactional patterns within the system.
This allows one to overcome loss, to concentrate on the most important elements of a situation, to adapt. It can provide the security to cope with difficult circumstances.
Helps one to practice and consolidate new functional behavioral patterns.
Low
----->-----> Willingness to change ----->----->
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Which task is the best choice depends on the problem and on the context of its solution, on the willingness of the client to change, and on the client’s resources. If we view counseling as a way of raising a client’s competence, then we must consider those tasks to be the best that “can be dealt with using subjectively experienced skills” (Schmidt, 2010, p. 113), i.e., those that support the client’s selfawareness of skills and help the client make progress.
5.10.1 Observational Tasks Observational tasks can introduce clarity and certainty to a situation – something that’s very useful and often necessary at the beginning of a consultation. Relevant information is collected for both the counselor and the client to ponder, and the willingness of the client to cooperate can be tested directly. The latter is especially necessary when the willingness to change is uncertain. And for many clients it can be comforting to simply be given something constructive to do this early on. With these tasks we can – Obtain more detailed information concerning how a problem occurs: “Could you please write down exactly how often you have headaches in the course of a week and how intense they are on a scale from 1 to 10.” – Discover the context and get a clear view of the problem at hand: “Please write down exactly how often you have a headache and note what you were doing in the five hours leading up to the headache (activities, persons you met with, place).” – “Please observe who first criticizes whom in the moments leading up to an argument.” – Focus one’s attention, also on resources: “In the next few weeks, please note what in your life you would like to change and what should stay the way it is.” – “In the coming weeks, note the ways in which Vanessa shows her willingness to help.” – Addressed to a teacher: “This week, in our group, Jessica showed considerable motivation to learn and things were more relaxed at home in the family. You could help us by observing Jessica in the next few days and letting us know even the slightest changes that occur in her school behavior.” – Addressed to a pupil experiencing school problems, especially with one of his teachers: “In the next week, please observe and write down everything your teacher says to you that is nice.” – To the teacher: “I spoke with Sven and his parents and said that he can’t go on treating you with such a lack of respect. His perceptions are very limited and he sees only the negative things around him. Thus, I’ve asked him to complete an observational task by registering only when and how often you are friendly to him. Maybe you could note whether his behavior does indeed change in this week.” These last observational tasks represent the attempt to intervene in a negative course of interaction by predicting a positive result or by giving the two interaction partners separate but complementary tasks. This is a positive use of the effect of the self-fulfilling prophecy. Marie Luise Reddemann (2007, p. 42) employed a so-called “hap-
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piness diary” to make her point, particularly with traumatized people or people stuck in their problems: The clients are asked to buy a particularly nice diary and to write down in it every day, every other day or twice a week, whichever is fitting, all the positive things they experienced on that day – regardless of how small they were. For someone experiencing difficult times, such a log can be a great help and a source of strength for surmounting everyday woes by observing the resources available – by “smelling the roses” along the way, regardless of how dusty and long that path may be. Such tasks can also be modified by asking the whole family to participate in a ritual and noting the results: “What did we do today to make each other happy? What was the highlight of everyone’s day?” – Emphasize means of gaining room to maneuver: “Please note when you feel depressed. Write down what you did that day, what you experienced.” – “Observe carefully what makes your daughter happy, which of your invitations to play she takes you up on.” – “Please note when you son goes to bed without raising (much of) a ruckus. Note what was different than usual.” – “One of you can put David to bed on odd days, the other on even days. Note what happens on the days he is particularly stubborn.” Clients can better maneuver when they observe the exceptions going on around them and the situations in which these exceptions occur – or when they observe the problematic behavior in a specific interaction context. The latter task has a similar effect to exacerbation questions (asking what would make things worse) or asking what factors have a particularly strong influence on the problem (see Chapter 5.3.2).
5.10.2 Ambivalence Tasks: “Do nothing!” or “More of the same!” This sort of task corresponds to the tenets described in Chapter 5.4.4 concerning working with ambivalence and the ambivalent mandates of clients described in Chapter 4.1.3. They are, as it were, the equivalent of extending ambivalent comments to concrete tasks: Clients are asked to continue or even increase their problematic behavior for the time being. The most important thing is to reframe the problem in a positive way that emphasizes the meaning and value of not changing one’s behavior. Thus, if high ambivalence is present toward change, the client can take a timeout or simply do nothing. Once the counselor has come down on the side of no change, the clients are free to explore the advantages of change without external pressure. Case example: A young man suffering from agoraphobia is still living with his parents. He says he “would have been long gone had it not been for his state,” but he clearly worries about leaving his mother alone with his father. We suggest he take his time. He should think about what sort of help his mother might need, how long he intends to live with his parents, the degree to which ehe is willing to sacrifice his own interests and where the limit is for him. (Hypothesis: The symptom is a way of solving another, very different problem, such as the mother’s loneliness or the son’s real fear of moving out.)
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Case example: To a young man who always reacts with stomach aches to conflicts in his relationship we suggest doing nothing since he needs more time to develop alternatives to help solve the problem. He could, for example, act “as if” and see whether that helps or not. (Hypothesis: His symptom protects him by softening the effects of conflicts.) Case example: One can suggest to clients that they need not actually initiate change but rather only think about change. Ask clients to think about this every day for half an hour to determine whether such a change would have any negative effects and what losses would accompany it. (Hypothesis: Symptoms serve to increase power and influence.) Case example: We could also ask clients to intensify their efforts. For instance, we could ask them to think even more intensely about their decisions, in order for them to discover what important message is contained within their “problematic behavior.”
As described in Chapter 5.4.4 concerning ambivalent comments, such a task demands a thorough look at the value of persistence within a system – something that must be defined very precisely if it is to play a role in motivating the client to carry out the task. The simple and superficial request to “keep the symptom for a while” will hardly have the proper effect.
5.10.3 Change Tasks Clients can also be given tasks that stimulate new behavioral and interaction patterns, and that enable new experiences on both levels. This method is useful when the client-counselor relationship is good and when the client is highly motivated to change. The task comprises the eschewing of established habits or the reworking of previous habits into new forms or temporal patterns, for example, the Milan group’s famous strategy of regulating behavior on odd or even days (see Selvini Palazzoli et al., 1979, and the example given below). This forces the client to do things either very intensely or to try out something completely new. Old patterns are interrupted, which in itself creates new experiences. At the same time, the counselor can make suggestions for alternative behaviors that are then discussed during counseling sessions (e.g., by asking about exceptions or working on specific scenes). Case example: A couple complaining about their son’s disobedience receives the task to divide up the responsibility for setting limits – the father on even days, the mother on odd days. They should, however, support each other and take note of which works better. This task interrupts the old pattern which consisted of the mother being responsible for setting limits and the father always criticizing her that her method wasn’t working. Case example: A woman who has been mourning a loss for a long time is unable to pull herself out of it and regain control of her life. One could suggest that she set aside one hour of every day to mourn and to plan her mourning time appropriately (candles, pictures, special place, etc.). At all other times, when sadness appears, she should postpone being sad to this hour of mourning and carry on with what she is doing. Or one suggests she take a week’s vacation and mourn intensely during this time, while ensuring that important people in her life are present. In both methods, one changes the temporal structure, and it
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is our experience that such a change has a good effect on clients: Grief has its own place and then moves aside to let other things in life become important again.
Tasks can also be prepared through interrogative methods or stagings. Case example: A client who had trouble saying “no” to the wishes of her immediate environment, was asked to practice role-playing during a session. The task, for the next week, was to alternate between very short and more exhaustive explanations whenever she had to say “no” to demands that she couldn’t fulfill. As is often the case, the client ended up overfulfilling her quotient, spontaneously saying “no” more than she had planned. She was encouraged most by the fact that she was not rejected or punished for doing so.
But tasks can also serve to delve very deeply into the structure of the system and actually activate changes in behavioral patterns. This is where we introduce methods from behavioral therapy, as the following example illustrates. Case example: A mother had been referred to counseling with her 11-year-old son Ken due to his violent outbursts in school. She shared an apartment on the ground floor of her mother’s house with her partner and a younger daughter. Her mother, the boy’s grandmother, lived upstairs. Ken had a room on the first floor, between his mother and his grandmother – the “most practical solution” considering the limited number of rooms in the house. So, in more senses than one, Ken lived in a sort of limbo between the two women and didn’t really know where he belonged. What he did know was how to play the two against each other and thus avoid all limits. It was our hypothesis that this in-between status was causing some of the problems, so we decided to invite the entire family, including the grandmother, to counseling. The two women were highly motivated to attack the problem, only to sabotage each other with negative remarks. The mother’s partner was hostile toward the whole procedure. Ken acted aggressive toward him, which didn’t help. At the same time, Ken expressed the wish to have more contact with his mother. Besides his problems at school, the following also was mentioned: Ken had been wetting the bed since his parents’ separation, he was severely overweight and was being teased at school because of it. His weight problems also had to do with the living situation: He had become accustomed to eating a meal with his mother and then going to his grandmother to “clean out” her refrigerator. To Ken, it was most important to focus on eliminating his bed-wetting, his mother and grandmother wanted to work on his weight problem. So we chose these as our main topics, as vehicles for working through the problematic patterns we were witnessing. To address the eating problem, we asked the two women to work together and set up some rules for Ken to follow, which would be enforced by the two women. The goals were that they coordinate their efforts and that they cooperate via mutual support, both of which were achieved relatively quickly. As to the bed-wetting, we suggested that only the mother should be concerned with this matter (our first attempt at strengthening the family boundaries). We chose a classic method from behavioral therapy and modified it for our purposes: The mother and son should use a calendar to register only the “dry” days. We asked the mother to sew seven little sacks and, as reinforcement, put a sort of voucher in each. She should first observe her son and then discuss with him something he would like to do with her (little activities such as buying an ice-cream cone, reading a story together, cooking something together, playing a game, etc.). Finally, she should write the activities down on the vouchers. Ken was then allowed to take one of the vouchers for every night he went without wetting the bed. The mother promised to redeem the voucher within a week’s time. The
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number of dry nights increased rapidly, and the mother kept her word. Thus, the amount of mother-and-son activities also increased considerably, leading to an increase in positive experiences. It was a touching scene after a few weeks in counseling, when Ken held a whole wad of vouchers in his hand and grinned from ear to ear: They were proof that he was going to spend a lot of time together with his mother. When we talked about this and asked whether his mother would perhaps be overwhelmed by the amount of vouchers, he said it didn’t really matter whether she redeemed each and every one of them – he was just happy to have her near him. This scene also said a lot about his many dry nights. With his growing self-esteem, we were now in the position to attack his school problems. The living situation didn’t change, but the boy now clearly belonged to his mother’s household. The mother was, once again, the person raising him, whereas the grandmother had taken a supporting role. One could chide us for using such a simple conditioning scheme in this case, or consider it a sad state that a boy had to “earn” his mother’s affections by not wetting the bed. But the really sad thing was how the mother had withdrawn her attention from Ken through a spiral of rejection and violent behavior. She had tried to shield her family and especially her new partner from her difficult son, but paid for his expulsion with a massively bad conscience. In this messy situation, we used the bed-wetting as a vehicle to invite the mother to once again take up her role as parent and to provide mother and son with the opportunity to have positive experiences with each other. This sort of reinforcement strategy should be seen primarily as a way of changing interaction patterns.
5.10.4 Rituals Like stories and metaphors, rituals are an age-old element of transitions, change and healing found in many cultures around the world. Von Schlippe and Schweitzer (2007, p. 191) note that psychotherapy, too, is a sort of ritual. Boscolo and Bertrando (1993, p. 282) even speak of reproducing the structure of transitional rites in therapy. In line with the thoughts of Evan Imber-Black (2003, personal communication) we differentiate between rituals according to theme: rituals of belonging, of healing, of reaffirming one’s identity, of expressing one’s own beliefs, of transition. In counseling and therapy, where the goal is to trigger change, the most important rituals concern life transitions, found in all cultures throughout processes of taking leave of the old and beginning something new: christening, initiation, wedding, burial, new job, retirement, to name but a few (see Chapter 5.12: LeaveTaking and Final Phase). The following case example, “Jessica’s ritual,” as well as the discussion on rituals stem from a contribution by Antony Williams (2003). Case example: “Jessica was a middle-aged woman who was very invested in her work and had collected many things she felt were important to her life. She had a large number of paintings and sculptures scattered throughout her apartment which took up every inch of the space. A number of them were by a famous painter who had been her partner and had died about 10 years back. She was unable to get over this loss and now lived very withdrawn.
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She took part in a training group where her problem was to be discussed. Together with the trainer, the group developed a ritual for Jessica that included the following instructions: ‘When you go home today, take all the pictures from your bedroom and put them somewhere safe. Now spend an hour of every day for the next month in this picture-less room, doing basically nothing. If you are on vacation, imagine the room and spend an hour there every day, as if you were at home in your own bedroom. And while you are sitting there, let the emptiness of the room have its effect on you. Ask yourself: What could change? Your birthday is coming up next month, so invite everyone you’d like to have around to a party for yourself and your friends. On your birthday you can change your bedroom in any way you want.’ Jessica accepted the ritual as prescribed. A year later, I met her again in a follow-up course. She reported the following changes: ‘Over the past year, I felt like I was living out in an open field, with nothing fixed. I have known for a while that I would like to live in my house with another man, but before I didn’t have the freedom to do so. It was too painful to feel the loss of my late friend – I don’t think I really ever said goodbye to him. I’ve become more creative in many ways: new fields of learning, music, travel. In my work I’ve experienced a number of difficult situations, but got through them better than ever. I am now better able to say no, and am better at seeing where my responsibility lies and where not. And I can say that to people directly. I used to have the tendency of loading myself down with all sorts of obligations. Now I feel safe in my own house, I can be there for and by myself, along with my loneliness or my wealth. I no longer need to be the guardian of his works of art, that is over, I can go shopping or just relax. I still go to my bedroom for an hour when things get difficult; to my empty bedroom.’”
The key elements of Jessica’s case example are as follows: – The ritual serves to introduce a different experience, a different perspective. The question is: “What sort of experience could bring Jessica to change her perspective?” – The ritual is a ceremonial element: removing the pictures, sitting in the room every day for an hour. Such behaviors have something sacred to them, in the sense of something special rather than religious. A good ceremony uses elements that have a meaning above and beyond the ordinary. The 30-day period and the 1-hour-a-day timespan both contrast with her everyday life. – The ritual includes a waiting time. Jessica’s not changing anything for a month had the goal of slowing things down so that she could see where she was headed. Even if, in the end, she had decided to hang the pictures back up in the bedroom (which could even have been part of the therapist’s plan), her intense contemplation on the matter would have introduced her to many alternatives. – At the end of the process lies a ceremony: Ending the ritual on her birthday made it clear to her that there are natural transitional points in one’s life cycle. It caused her to pause and think about what had changed in her life. The difference between rituals and other tasks We often employ tasks in family therapy. And rituals are a special sort of task. Both tasks and rituals are responsible for changes that take place between sessions. They serve to trigger new thoughts and new behavior patterns in clients.
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Tasks are sometimes used to test a hypothesis, to introduce new perspectives to the situation and thus, hopefully, to bring about important breakthroughs. Rituals, on the other hand, act rather transformatively: They create a new order in a client’s life or even within the client directly by adapting elements of sacrifice, penitence and enlightenment. They bring light to the jungle and allow attitudes to be modified and new constructs to arise. Whereas tasks are aimed at the mundane routines of everyday life, rituals address more major questions such as belonging, healing old wounds, identity and basic convictions. They create a unique level of time and space and use symbolic means to produce reorientation processes. A ritual takes up the client’s old patterns – only to change or expand on them. In the example above, the ritual enabled Jessica to accept the power her past had over her present life, while at the same time playing with the possibility of change. Her sorrow was represented (and even amplified) by the empty room, whereas the birthday party signaled her new life. The elements of a new ritual Rituals serve to both mark and encourage the transition from one stage of being to another. Carrying out rituals can sometimes take weeks or even months, although their actual execution may not always be that important. The process of preparing for transition, the direct experience and the reintegration into everyday life may carry more weight. Rituals performed in a group context have four parts: Separation: Transitional rituals release the actors from their earlier roles (e.g., adolescents progressing to adulthood). This is often accompanied by metaphors of death, loss of status, symbols of nakedness, vulnerability and dissolution. Emotional pressure builds up, and those involved are completely focused on future events. Jessica had to wait an entire month before she was allowed to make any decisions concerning the paintings. Preparation: Preparation is probably the most important part of the ritual, even if we are usually concentrated on actually experiencing the final act. Preparations for a wedding, for example, can last an entire year, though the actual ceremony lasts only an hour. During preparation, the participants are occupied with clothes, colors, materials, food, drinks, songs, dancing and scheduling special events. We don’t need anything exotic: through the power of symbols the ordinary can have great impact (“Wear your favorite red shirt, go to the market on Saturday morning and get two of the most beautiful and ripest eggplants”). Enactment: During the enactment of the ritual, the client should not only say or think something but be physically active. In one way or another, the ritual must be difficult to perform, although it is wise to embed these actions into something that the client generally likes to do. These actions should lie somewhere inbetween difficult and easy: If they are too easy, the ritual loses its meaning. If they are too hard (i.e., too confusing, too expensive, too demanding, too different from one’s basic values), then the client may refuse to do them. The enactment uses
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special behaviors and symbols – it demands a certain time and space and sequence lying somewhere between predetermined and selectable events. One should carefully study existing solution patterns and resources, and use them to create new meanings by liberating them from their normal references: Jessica’s bedroom is not only a bedroom, but also a very special room in which she makes important decisions. Celebration: This is the last stage of transitional rituals. Here, we return to the community with our new status. This part of the ritual has a collective dimension to it, which helps us to accept our new role or new stage in life. A celebration nearly always implies the acceptance of a loss in order to begin something new: Jessica had a birthday party with her friends at the end of her ritual. The idea behind the ritual is not to provide the protagonist with good advice about how to live life, but rather to use the power of the ceremony to bring the client to see new perspectives and new meaning in life. One can never be quite sure which perspectives and which meaning a client will take away from a ritual. That is why we use symbols and symbolic actions that are always at least slightly ambiguous: This allows clients to construct their own meaning.
5.10.5 Practicing New Behaviors If change is occurring, but the situation is still instable, one can provide alternative behavioral patterns as part of the task. This helps the client to practice and consolidate what is new and already functioning. It has the advantage of being limited to a sort of pilot project or dry run for a predetermined length of time, say, “the first day of the week” or “one week long.” This keeps the task manageable and implies that it is acceptable to validate and, if necessary, fine-tune the result. Case example: In a group of adolescents new rules are being discussed and established. The group decides to try out the rules for a period of four weeks and then to judge what the advantages and disadvantages are. Case example: A single mother has practiced accepting help from her parents and asking her friends for help whenever necessary. She’s still somewhat apprehensive about changing her relationships and being on the receiving instead of the giving end. We reach an agreement that she should try it out for the next four weeks and see what happens. Then we could discuss everything. Case example: A client from an assisted living home for the mentally ill has learned to apply some new ways of structuring her day, and now she wants to try them out on her own. She and her counselor arrange for them to meet every other week to talk about the results of her experiment.
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5.11 Accompanying and Supporting Changes Imagine: A number of questions have been posed and answered, a sculpture or two have provided important impulses, the client is positively surprised by some comments and has even mastered a task with amazing results. We witness the first signs of change – what now? In the past, therapists who thought things were moving too quickly spoke of “transference healing” and remained skeptical about whether the light at the end of the tunnel was truly in sight. After all, relapses could happen at any time. And “good” clients took heed of this skepticism. Today, we can better appraise such results and would like to suggest three ways to approach such situations. We also provide a couple of methodological tips.
5.11.1 How to Be Supportive Be positive about change: The midwife Anyone who has observed Virginia Satir and Insoo Kim Berg at work, with their very different personal styles, discovers atleastonecommoncharacteristic:Theybothgreet the statements of their clients both verbally and nonverbally with great pleasure, like a midwife delivering a new human being into this world with a smile on her face and real joy. This attitude is a good approach to use from the very beginning – and even more so when initial successes are being reported. It is no coincidence that Virginia Satir put so much emphasis on self-esteem. Most clients are not blessed with a stable self-esteem. Reacting to the changes in their life supports this process. Reclaiming land by connecting the islands Every positive change, however small it may be, should be seen as a new island in the sun – to be greeted with great joy and cared for immediately, so that it doesn’t get flooded again. Always keep in mind that waves may come at any time and reflood everything. That’s what it means to be born: Life is full of adventures! Don’t succumb to skepticism and grumpiness, but rather assume that one island leads to another and then start networking them. The Dutch have considerable experience in this procedure, and anyone in need of proper illustrative materials should take a look at the writings of Maria Aarts (2009) on the Marte Meo method. If you prefer a more horticultural approach: Once the seed of change has been sowed and the soil has been prepared, the first leaves will pop up and look very much like weeds. The art of gardening is to recognize the difference, to nurture and care for the seedlings and to protect them from being trampled on. Only in this way can changes become viable plants that, together with other plants, form a garden of true beauty. Of course, we are talking here about a truly biological garden that can withstand the presence of a “weed” or two. Being positive: Joy, humor, pleasure Nossrat Peseschkian (2007a) called his approach “Positive Psychotherapy,” and a group of researchers in the United States under the banner of “positive psychology”
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studied the key factors to a successful life (Seligman, 2012). Both groups showed how important it is for individuals to have a positive attitude toward their own – and other people’s – productivity, development and change. A positive mood and a positive attitude toward one’s relationships are very important, as are humor, joy and pleasure. That these things are conducive to living a good life is also reflected in some of the theories quoted above, such as synergetics (Haken & Schiepek, 2010) and in the research results of Grawe (2000, 2005). Today, many different, groundbreaking results are emerging from the research being done by Seligmann’s group, which proved that maintaining a good mood – however it may arise, through humor, a good meal or a friendly conversation – can increase one’s performance immensely: Humans work better, more concentratedly and productively – doctors are better at diagnosing their patients – when in a good mood (Seligman, 2012, pp. 70 ff.). The newest results from neurobiology also confirm the hypothesis that new circuits in neuronal networks are established more quickly in the presence of positive emotional states (see Hüther & Rüther, 2010, pp. 224 ff.).
5.11.2 Cheerleading and Asset Growth The term cheerleading (Walter & Peller, 1992) describes concisely what we mentioned above. What we mean becomes clearer if we take the term apart: cheering and leading. By praising (small) changes, getting hyped up about them and celebrating them, we can lead people to achieve even greater changes in their lives – to become even more courageous and more confident in their own abilities. According to Walter and Peller (1992) as well as Durrant (1993) four questions or comments promote this attitude: – “How did you come to the decision to do something new and surprising?” Questions of this sort address the client’s own initiative and decisiveness. Often one gets a rather vague answer to such questions since people tend not to think very intensely about their actions. But that is of no consequence, since our objective is to direct the clients’ attention to the fact that they decided on their own. That is what we are praising. Such questions are powerful even if we fail to receive a clear answer after repeated querying. – “How exactly did you do it, how were you able to manage it?” This question, or similar ones, demand detailed answers and usually serve to illuminate problems. Here, however, they are employed to explore successful strategies – to discover what course of behavior or action led to the eventual success. This is important for clients who often have little awareness of how positive results actually come about. In this sense, this method can support further successes and change. – “What is your explanation for how this has suddenly become possible?” We always enquire about the clients’ own theories, how they explain things, to get insights into how to construct future changes.
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– “That is fantastic!” There should be a basic level of enthusiasm. Of course, no counselor can “practice” being excited. Rather, as often mentioned above, the most important thing is one’s inner posture: How can I authentically reflect back to a client who may be stuck in any number of problems how dramatic it truly is when he finally begins doing things differently?
Here are some questions taken from a conversation with an adolescent who had been convicted of assault and was participating in a social rehabilitation program: Case example: “So you were being provoked while in a bar and didn’t hit back. I think that’s fantastic! That is a major step for you, maybe we should write to Guinness Book of World Records. But how did you decide to act as you did? – What made you decide not to hit back? – What exactly did you do and think while you were in the situation? – That means that for the first time, you thought about the consequences before acting, I mean, hitting back or accosting the other guy. That is something completely new for you! What did your friends say about it? – And your girlfriend? And how did the other guy react – he was probably just waiting for you to go at it, knowing how you usually react? – What’s your theory on how you were able to hold back this time? I realize that’s a lot of annoying questions, but you know how I am – I always want to know everything in great detail, mostly because I think it’s just great the way you handled yourself.”
Capital gain, in this context, has nothing to do with money! Rather, it means what clients accumulate by solving their own problems and by reaching their goals. Clients often see themselves as weak and dependent. Solutions lie beyond their means, beyond their control and beyond their influence. Case example: “It just took ahold of me.” – “I didn’t have a choice but to . . .” – “There’s nothing I can do about it . . .” – “Well, because I’m sick . . .”
Accompanying changes means expanding clients’ horizon and enlarging their area of control and influence. And that always begins with their consciousness! For this reason, we always question their lack of control and their presumed absence of influence: Case example: “When does it take ahold of you – and when doesn’t it? What happens before that? Have you experienced situations in life where you acted differently? What do other people do in such situations?”
We point out changes and describe them as positive and a sign of the client’s success: Case example: “How did you manage to . . . Sometimes things work out, don’t they? How is it that in some situations you forget you have that skill? What did you do to stop or cut short your rampage? How did you do that?”
There is a Chinese saying: “If you want to lead people, go behind them.” This piece of wisdom, originally meant for managers, fits the following tale: Case example: A nurse who worked in a rehabilitation center was accustomed to taking the patients out on their daily walk, to strengthen their motor capabilities. She would link arms and go up and down the halls with them. Then she made the following observation:
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If you go slightly faster than the patient it makes them feel insecure – they feel like they’re being tugged along and rushed to go faster – they become fearful and overly careful. However, if you go slightly slower than the patient, minimally behind them, they feel more secure and walk on their own with more confidence: The walk turns into a pleasing act.
In our counseling work, this means using existing approaches with clients, supporting them and helping them. Our interventions must befit the time, pace and habits of the client.
5.11.3 A Climate of Change German culture is very focused on revealing deficits. In some Oriental cultures, in contrast, doctors were paid to keep their patients healthy. German anamnestic practice also centers on reporting deficits. We need drastic changes here if we want to systematically work in a more resource-oriented way in the future. We are well aware that this stands in contrast to the demands expressed by those footing the bill, who will only approve counseling if the client exhibits extreme deficits. Here are some questions one can introduce in routine situations to support a climate of change (Durrant, 1993): – Files or reports: What sort of evidence is there that the behavior has changed for the better? That the client has made progress? That it is worthwhile to continue? Under what circumstances could the old behavior have turned up – but didn’t? What did the client do differently, what was a surprise? – Case discussions: What went better this week? Were there any noticeable changes? What does this relapse have to tell us? This negative result? How did we judge the problem? Can it be seen differently? Could we react differently to it? – Everyday situations (meals, trips, games): Here, too, many clients fail to see the buds of change and trample on them before they can become viable plants. So here, too, we need to point out that exceptions and small changes are possible and to remark positively on them, for example, through short comments.
5.11.4 On Relapses and Incidents Second-order cybernetics have taught us that we must always remain cognizant of the observer’s contribution to the observed events. What we talk about, what we do, which topics we meet with a smile and which ones make us furrow our brow, the words we choose – all of these things have an influence on the clients: Our actions focus their attention. The word “relapse” is a good example: On the one hand, it has something to do with falling backwards, not going forward, not running and jumping but being passive (“it” happened – again!). On the other hand, it clearly marks a direction: backwards, not sideways, not even slowly forward (is there actually such a thing in human development as going backwards?). Thus, when we speak of relapses, we are conjuring up images that are not very conducive to change:
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– We are talking about illness, personality structure, basic disorders, deficits, irreversible traumatization instead of: “The client has the tendency, a general disposition, that repeatedly leads to his . . .” – Pessimistic expectations: “The behavior recurs again and again.” – “Again and again, in autumn . . .” – “. . . when under stress . . .” – “. . . every time, when . . .” – Although small changes did occur or perhaps were overlooked: “The same behavior is repeatedly shown.” – The concept of loss of control: The behavior overcomes someone like an uninvited guest. – Worst of all: a “relapse” that invalidates all previous successes. It reveals which stage has “actually” been reached: The client is “not ready” – not by a long shot. This leads to pessimism and despair among both clients and counselors.
This can easily turn into a self-fulfilling prophecy: Even the slightest signs are interpreted as precursors to an impending relapse, which in turn leads to certain reactions in the clients and their environment – which then set off (or cement) problematic spirals of behavioral reactions. Gunther Schmidt (2010, pp. 361 ff.) emphatically notes that such processes can serve as hypnotic suggestions that, in the end, create the very phenomena one is trying to avoid. It is worth it to try and develop a different approach to and a different vocabulary for such phenomena. Whenever we speak of “relapse,” clients immediately resort to old behavioral patterns, which implies that the client has been able to cope without them (at least for a while) and has developed alternative patterns: The client has thus successfully exhibited the basic competence of living with appropriate patterns. In such a context, nothing stops us from speaking not of a “relapse,” but rather of an “incident” or “rerun” (Schmidt, 2010, p. 371) and thus to view the behavior through systemic glasses. And we must ask why someone would – under these specific circumstances – want to revert to old patterns. What are the questions and what are the challenges such behavior is trying to satisfy? A few methodological suggestions Avoid using the word “relapse”: Instead, say “recourse,” “rerun,” “revisit,” “old” pattern versus “new” pattern. This linguistic change alone can conjure up other associations and images and helps the client to think in problem-solving categories. Present it as something normal: Don’t wait but try to imagine in advance the circumstances under which such an event might occur. What would the client (or the client’s relatives, significant other, etc.) have to do to trigger such an “incident”? This way one can work out the contextual circumstances that might lead up to it. Once it is viewed as “normal” to sometimes revert to old patterns, clients must no longer be afraid of the damning verdict that previous progress can somehow go down the drain when “mishaps” occur. Once in a while, we all revert to old, unwelcome patterns we thought were long gone. Even the occasional counselor has been known to do this.
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What if you were to simply skip the revisit?: Such a paradoxical question can lead to a metalevel and help the clients to put some space between themselves and their problems – to see the matter as unpleasant, but not completely without hope. We can also ask whether it would be of some advantage to repeat some of the old stuff occasionally, and what damage would be caused by refraining from these repetitions. Case example: “Who would be most irritated if you were to continue striding toward your goal so determinedly? Who would miss the pleasure (and gloating) of seeing you fail if you never stumbled along the way? Who was always convinced you wouldn’t make it anyway? Might it possibly be useful or important to provide such people with a little reassurance every once in a while?”
The feigned revisit: acting as if: If the client’s development were to run contrary to the interests of others, feigning a relapse may in fact be helpful. Case example: Imagine a mother who wants her daughter to be unsuccessful in life and is always prophesying her imminent failure. Thinking through and planning how and when the client could enact a repetition, for example, how she has to stay at home because of her depression, calling her mother and bemoaning her fate, can introduce a very creative, positive tone into dealing with the repetition of old behavior.
Talk about and plan alternative behavior: If we see a situation coming in which reverting to old patterns will appear to be the best solution, we should openly talk about alternatives. Case example: What can the client do that is similar and has the same meaning but not at such a high price? Perhaps she could have a rest instead of becoming depressed; she could call a friend instead of going out to get something to drink; she could immediately leave her apartment instead of letting the dispute escalate and become violent.
Redesigning the revisit: If, however, behavioral repetition does occur, despite all precautions, one can discuss how it can take a less radical course. Case example: “Whenever you notice that you’re beginning to slide into depressive feelings, what can you do to immediately snap out of it?” – “If you decide to skip school again, what could you do to ensure that it won’t be weeks before you return?”
But what if “it” still happens? Systemic work with incidents “Incident,” not “relapse”: As described above, using the right vocabulary is important. One should make clear that the event is normal in the course of a long developmental process. Differentiation: “What was different than usual?” It is important to determine what the differences are to earlier behaviors in similar circumstances. This dispels the pessimistic viewpoint that one has, in fact, exhibited the “same” behavior as in the past. Providing new meaning and function (reframing): This method is similar to that used in other systemic situations – though on the other hand it is somewhat more
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difficult here since the client (and sometimes the counselor) must swim against the stream of inner disappointment. And yet it is clearly the key to working with relapses: Describing the incident from the new, present vantage point and understanding it as an attempt at resolving an existing challenge – not as a plump, passive reversion to old patterns. We can describe it as follows: – A sign of stress: “This was a particularly difficult test run for you. Clearly, you fled back to the warm nest, since the new course of action – which you’ve used in many situations very adequately – didn’t succeed so well. You could learn from this how to avoid certain situations for the time being, or accept that reruns will sometimes occur.” – The attempt to regain one’s balance: “It’s interesting that you’ve become depressive at this particular juncture, when you’ve asserted yourself in two different conflicts and now another one was in the making. It’s almost as if you didn’t want to ask too much of your partner by showing your self-confidence a third time. What makes you afraid of acting like you did in the previous situations?” – The attempt to satisfy old demands: “It seems to me that something in you is telling you your parents are not yet ready to see you as the independent daughter that you are. And you are a very loving daughter who would, if need be, give up that independent life for the sake of her parents. Maybe you felt that your parents were struggling with the idea of you as a young responsible adult and neglected things for this reason.” – Repeating something to see how it used to be: “So now you’ve proven that you are able to go to school on a regular basis. Maybe you just wanted to experience once more what it felt like to skip the daily grind of school and hang out with the boys instead. Maybe you just wanted to check out what you really want to do: Succeed in school or travel the path your father did, not worrying about educational matters and just keeping an eye out for opportunities to earn a bit of money here and there.” – The desire for autonomy (resistance to external influences, be it helpers or other well-meaning individuals): “We’ve really been working hard to see how you can change. Maybe I was going too fast and you needed to show me that you have your own pace of doing things and want to choose the order in which you take the next steps. You’ve distanced yourself from your parents’ demands and found your own path. Maybe you adapted to my demands as counselor, and I was excited about the progress you’ve been making. But now you’re showing that you need to take a break, and that’s a good thing.” Providing consolation and encouragement: This may be one of the most important elements of all. Sometimes it is sufficient for the counselor to console and encourage the client to “suck it up” and get back in the saddle – this also implies that it’s OK to sometimes stumble on one’s new path, and it implies that you are confident that the stumbling will eventually stop and that the client will then once again take up the journey.
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5.12 Leave-Taking and Final Phases “Begin with the end in mind.” That was the motto Stephen Covey suggests in his rather sensationalist-sounding, but nevertheless very readable book “The Seven Habits of Highly Effective People” (2004, pp. 96 ff.) when developing strategies for life in the light of one’s own finiteness. This suggestion can easily be adopted in counseling, therapy or caretaking as well. For professional help should, wherever possible, accompany transitions and problem-solving processes and thus be limited in duration and scope. Yet the literature, even systemic literature, says little about how to go about shaping such parting processes.
5.12.1 The Dynamics of Parting Processes Partings can mark a new beginning and thus be an occasion for relief and joy. But partings can also entail separation and loss. Clients often have already experienced unresolved partings full of great emotional pain before entering counseling. Imminent partings, also those from professional relationships, may activate earlier experiences. The dissolution of a common bond and the fear of losing an attachment may trigger resistance patterns to avoid dealing with emerging feelings. This, in turn, can cause any number of behaviors that serve to avoid or delay the parting. The following invitation is popular among counselors: “If you’re not doing so well, if you’re experiencing a crisis, then of course you can come back.” Such a statement, however, may have the effect of evoking a crisis in order to continue the contact. Or, at the end of a seminar, one can plan the next meeting, make plans when and where everyone can get together again. Or the subject is avoided altogether. Case example: About 20 years ago as a supervisor in a children’s home, I (R. S.) experienced how a female colleague left after many years of service. She would be gone at the end of the week, she said. When I asked her how she planned to say goodbye to the children, something that was surely difficult for everyone, she agreed, especially in light of the many goodbyes these children had experienced in their short lives. For that reason she had decided not to say anything in advance but to simply announce to them her leaving on the last day to keep from making it so hard on everyone.
Thankfully, such forms of “considerateness” are rare. Nevertheless, there are many ways of taking leave, on a professional level too. There are many behaviors that serve to avoid sadness, pain and sometimes anxiety about what will follow. Psychotherapeutic concepts of defense mechanisms can provide many revealing ideas to avoid interpreting such behaviors as unpleasant maneuvers but rather as ways of protecting oneself. (This insight and the following list comes courtesy of our colleague Erika Lützner-Lay.) Patterns of leave-taking – Devaluation: To make it easier to part from someone, some people depreciate the past. Adolescents are masters at this and counselors are often at the receiving
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end. When subjected to such treatment, it can sometimes help to be aware of it: “It was over anyway . . . boring . . . didn’t really help me anymore . . . the other counselor knew me better.” Anticipating separation: Appointments are missed, clients stop contacting us. Even after a good stretch of work there comes an abrupt, unexplainable break. This runs according to the pattern: “Before you go, I’ll go. I’ll lead the way.” Denial: “It’s no good to talk about saying goodbye. It happens and then it’s over. There’s so much time left anyway.” Regression: Clients develop new or old symptoms during the parting phases in order to keep up the contact. Dramatizing, blackmailing: “I can’t do this, I’ll never survive it.” – “If you end things now, then it’s all over – I’ll kill myself.” Projection, personalizing: “It seems to me you want me to go. There are probably a lot of other clients just waiting for my spot, who need it more than me or who are easier to get along with.” Rationalizing: Talking about the end is a very sober matter, with no feelings expressed at all. “That’s the way it is, everything must pass. Things begin and things end, every ending is a new beginning.” Avoid, distract, delay: Whenever the conversation turns to saying goodbye, the subject is changed or ideas are discussed about what would still be possible, as given in the above-mentioned example from a seminar group: “Did you see that great movie . . .” – “Couldn’t we try to . . .” Quarreling: The final phase results in sudden conflicts that have nothing to do with the theme of parting. In this sense, this pattern is similar to that of devaluation, since it serves to ignore the pending change.
Case example: A few of my (R. S.) professional years were spent as head of a youth center within a counseling and guidancecenter, where I worked with a female colleague andan intern. When I was to leave that position, I gave notice about 8 weeks in advance. Most of the adolescents accepted the news calmly and quickly returned to their daily routines. The next day there were only very few youths at the center, and those who had come got into fights with the staff about any little thing. This situation went on for a few days. We were frustrated about this development since we were planning a going-away party and wanted to include the youths in our plans. Only after expressly mentioning these new dynamics and talking about the leave-taking and what feelings can arise in such situations did the quarreling stop and real conversations become possible. The adolescents voiced concerns about what would happen to the center, whether they would ever see me again: “Why are you leaving – did you find something better?” Their sadness, regret and interest in my future all came to the forefront.
Situations involving good-byes are intersections in life that remind us of earlier, sometimes painful incisions. The leave-taking phase should thus be planned well in advance. It is a time to take stock, to determine what be worked out and what can no longer be completely solved. Getting through such a separation and experiencing the feelings associated with it is a necessary process for coping with it and for becoming able to take up new relationships. This is especially true for inpatient contexts, in order to make life easier for the next colleague.
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Background Text: Phases in the Process of Leave-Taking A review of the literature yields numerous descriptions of separation processes. An attempt to describe the typical phases is probably as futile as all classification systems, since life has the tendency to stray from designated courses. Still – sometimes it can be helpful to remind oneself what processes and phenomena usually occur in order to better understand them and to avoid pathologizing something that is a very normal reaction to a painful loss. Below, we compare two phase models described by Elisabeth Kübler-Ross and Verena Kast. The interesting thing about these two models is that their authors focus on very different aspects of leave-taking and still arrive at more or less the same conclusions (Table 14). When working with grieving clients it is especially useful to be aware of the various forms the process can take. Also, when planning good-byes it can be helpful to assume that there are universal ways of reacting to this type of farewell – especially when one has worked with a client for a long time (e.g., in family guidance, counseling centers or in assisted-living), if one has participated in their daily lives (in inpatient or daytime care contexts), if treatment has taken a good course and one has established a good relationship, or if major crises have been tackled and dealt with, or if very stressful matters were successfully solved.
Table 14: Phase models of leave-taking processes Elisabeth Kübler-Ross (2008)
Verena Kast (2002, 2013)
Focuses on what goes on in a dying person, e.g., the emotional reactions to receiving a terminal diagnosis
Focuses on how persons who are grieving or feeling left behind deal with their loss
1. Denial: not wanting and unable to admit something is true
1. Refusing to believe: feelings are blocked, emotional rigidity as means of protection
2. Anger/rage: Why me?
2. Feelings break through: anger, grief, anxiety, relief, guilt, pain
3. Bargaining: trying to change the fact 4. Sadness/depression: when all attempts at change have failed 5. Acceptance, consent, conscious approach to the situation and the time one has left
3. Phase of seeking and separation: understanding sets in, interrupted by “contacts” with the departed person (inner dialogs)
6. Reorientation: What will I do with the rest of my life?
4. Phase of a new view of life and oneself
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5.12.2 Shaping the Final Phases Within the self-awareness sessions that are part of our training program, we compile a list of components named by the participants as prerequisites to a positive separation experience. The elements that always make it on the list are time, acceptance of a wide variety feelings and behaviors, good friends and conversation partners, rituals, small and large gestures of consolation. These are means of achieving proper leave-taking in professional situations. We divide the following ideas into (1) dealing with this issue while still working together and (2) shaping the actual act of going separate ways. The beginning and middle of the process Determining out the agenda at the beginning: Concretely defining goals at the beginning already includes the end of the process and helps to keep in mind that one is dealing with a limited professional relationship. Many clients, particularly those with relatively few contacts, tend to see more in the relationship than is really there. The sometimes exaggerated prognoses for healing made by the counselor meet with the relationship desires of the client and extend the whole process unnecessarily. So it’s useful to set up an initial goal and to set the course for ending the relationship from the very beginning. Scaling questions can be methodologically useful in this situation. Case example: “How much – what percentage – of the problem should be solved by the end of our sessions? How much will you then be able to solve on your own? What needs to have been solved, rebuilt, changed or whatever so that both of us can terminate the relationship with a good feeling and say: It was worth it?” For inpatient institutions Durrant (1993) suggests using specific actions to ease transitions and to frame the treatment. A participant from one of our courses provided us with the following good example: A photo album is compiled for every child at the onset of his stay at an inpatient educational institution. This album, the child is told, will be handed out to the child upon leaving the institution. It serves to document the most important stations and experiences with photos and other small mementos. Such an approach thus already includes the act of leaving. The child takes along a sort of personal history, a memoir that, in the moment of separation, can also serve as a transitional object (Winnicott, 1965, p. 143).
Mentioning the end early on: This can be incorporated into periodical evaluations which look back on the original goals and consider what has been achieved thus far. It also reminds us that the counseling relationship is not one made for eternity. This method can, to a limited extent, also be employed in long-term inpatient contexts. Appreciating small steps and emphasizing the client’s role in successes: When working with a client it is advantageous to emphasize the little successes achieved along the way and to emphasize the part the client has played in their achievement. This strengthens the client’s self-esteem, directs attention to existing re-
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sources, and encourages the client to one day start mastering the smaller and larger challenges of life on her own again. Building up a social network (see Chapter 5.7): A functioning social network is particularly important during any separation phase, but it also plays a major role in the long-term stabilization of clients. The relationship and support found in professional settings must, slowly but surely, be established in personal circumstances as well. This is especially true for clients with a rather weak social background, who tend to become dependent on professional help and run the risk of encountering new problems that delay the leave-taking process: These clients literally have no one else to talk to. The actual separation phase Looking back on the course, successes, pending problems: Every separation should include a look back. We look at the course of counseling with all its highs and lows, see what has succeeded, what insights have been gained, what strengths have been (re)discovered, what new resources have been added. This creates a positive evaluation of the work done. Clients can also learn to prepare themselves for the future blows of fate by seeing how they coped with past ones. Besides conversational methods we can also use sculptures and visualizations, work with timelines, paintings, room distributions – whatever – to better present the results and make them more memorable (on the tools for doing this, see Chapter 5.1). But part of such a review is also being critical and talking about unsolved problems with the counselor. Counselors should own up to their own limits and discuss with the clients where and how they can deal with unfinished business. Room for feelings: There can be many feelings present when taking leave: anger about being abandoned, sadness about things coming to an end, relief or anxiety at missing support. Be prepared to experience the entire spectrum of emotions and try to take them all in and honor them respectfully. But remember, too: Counselors have their own patterns of saying goodbye, and it is just as important to be aware of these feelings to avoid pressuring clients into an unwanted discussion about their feelings or to purposefully avoid mentioning them and cutting off the contact. Reestablishing system limits: Every counseling or support relationship has the effect of dissolving system limits. At the end of the counseling regimen these should be properly reestablished. For example, in inpatient settings one can arrange for an official handing over of the key and a statement explaining when and where the client can have access in order to make clear that a phase is ending. Such rituals can provoke strong feelings, which are important when coping with the true end of something. Sometimes clients suggest meeting occasionally for a cup of coffee to continue the relationship on another level. Here it is wise to respectfully but clearly draw the line. Balancing the relationship: At the end of any counseling process, it is helpful to rebalance any asymmetrical relationship that has arisen because the parties were
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designated the helper and the helped. Counselors can relate personal anecdotes and demonstrate what they have learned from the common sessions, though one should take care to avoid raising expectations of an extended relationship. This implicitly shows that the asymmetrical relationship, too, is coming to an end. Outlook and perspectives: Like a review of the past, an outlook on the future is an integral part of any separation. One speaks of perspectives, encourages confidence and, by pointing up the skills learned, once again mentions the possible stumbling blocks and how they can be overcome. This is a sort of prophylaxis against a relapse, as described in the previous chapter in more detail. There will always be clients who suffer from such massive impairments that they will have to seek out professional help once again in the future. We as counselors can reduce their anxiety by setting the threshold low and letting them know that help is always available in times of crisis. To avoid that becoming an invitation to produce crises in order to get help, we have found is good to signal an innate interest in the client’s problem and signal one’s availability even in the absence of problems. Case example: “Of course, you can always give me a call if you need professional help and think you can’t make it on your own. But then again, you don’t always need to have a crisis to get in touch with me. It’d be great if you contact me in a year or so to let me know that you’re doing OK.”
Building up a social network: In times of parting it can be helpful to speak about the role the support relationship has had and where the client can arrange for a replacement – who can offer advice, consolation, encouragement, support and, sometimes, a confrontation or two. As mentioned, this conversation should not take place during the very last session. Rituals and transition objects: These are an integral part of any leave-taking and transition. They can be very small things at the end of a short consultation, or a cup of coffee and some cookies at the end of a longer period of counseling. How this is best done should be discussed with the client. Special appreciation is expressed by having the ritual include personal elements such as a favorite meal, a song or a poem specially written for the occasion, a photo collage, symbolic presents that say: “All the best for your journey through life!” In our experience, small presents are especially important because they express the counselor’s desire for the client’s well-being – and serve as transition objects sensu Winnicott (1965, pp. 143 ff.). Examples are a stone from a collection on the counselor’s desk as a reminder of the good cooperation; or some other object that symbolically stands for the most important topics and successes of the therapy. When clients avoid saying good-bye and break off the contact shortly before the scheduled end: In such cases we usually demand there be a final session, something that has proved to be very productive in the past. Without a final conversation everything remains open and unfinished, and any accidental meetings thereafter can be very embarrassing and give rise to false assumptions and presump-
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tions. If the client refuses to take part in a final session, it is recommended that the counselor write a short letter and then declare the process completed. Try to see the client’s absence as something positive, offer a final conversation, but respect the client’s autonomy. Always send your best wishes for the future. 5.13 WhenIsitBesttoDoWhat?IsThereSuchaThingasaTypicalCourse?
5.13 When Is it Best to Do What? Is There Such a Thing as a Typical Course? It would be presumptuous of us to offer a simple answer to this question. There are many different client systems out there, each with its own patterns and contexts, observed by counselors with very different mental models and methods in various settings – thus there is also a large range of possible courses. We are reminded of the words of Milton Erickson, who said that every family deserves its own school of therapy. This reflects the broad variations present in professional approaches, from solution-oriented ones (Hargens, 2006) that treat every session as the initial session, to models that describe phase-specific themes and interventions (Haley, 2007; Gammer, 1999, 2005). Let us thus praise the systemic spectrum: It provides a freedom to decide what model best fits us. Perhaps we can let our constructivist approach lead us toward an understanding that nothing is ever completely wrong or completely right. Let us remain ever curious about why other colleagues have, in various contexts and in light of numerous personal or professional traditions, chosen one variation over another. Maybe we help our clients best when we are not attached to any one method, but rather carry with us in our toolbox a whole array of alternatives. When it comes to deciding which one to choose, we would like to refer the reader to the two poles described below. Please note, however, that it has been our experience that it is most helpful to steer a rather meandering middle course. A very broad phase model for family therapy was suggested by Carol Gammer (1983), who was a teacher of one of the authors of this work (R. S.). She posits three phases that may be delineated and contracted separately. In the first phase one works on the symptoms, the client’s ostensible problem. This is the first goal to be contracted. With reference to this symptom/problem the intervention is planned in a way that facilitates change in the family’s interaction patterns (vehicle development). Once the most important symptoms have been eliminated or at least mitigated, it can be meaningful or even desirable to turn to more general family issues: questions of interaction, baggage from the original families, developmental matters in the family, etc. Now trust has begun to grow and perhaps more difficult topics have come to the forefront which were previously hiding behind the symptoms. This second phase can be followed by a third phase, one of couples therapy, during which we discuss matters of the couple’s day-to-day life, their marriage and intimacy. Phases 2 and 3 are carried out only if the clients express the specific need and the counselor deems the issues appropriate for counseling. These phases can also serve the goal of prevention.
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This model sounds like it will lead to a lot of sessions and is thus a good way to keep therapists well employed. But it has its own internal logic and also contains a number of important suggestions. For example, the growing conviction (won after much clinical experience) that working successfully with the client during the first few sessions serves to establish trust and allows the later discussion of difficult, shameful or otherwise tabooed matters. And it contains a very important warning: This concept differentiates between the parental and the couple’s levels and suggests starting off by paying more attention to the parent level or approaching the family system by concentrating on the symptoms. More personal topics demand the protection offered by trust that has evolved over time. The conviction expressed in the early days of family therapy that every symptom shields a couple’s problem eventually led counselors to proceed too quickly to the couple’s level to seek out the “real” problem. Case example: A family with a bedwetting boy came to us and said a colleague had suggested early on that they go to couples therapy. Though they found the therapy to be very interesting, the boy was still wetting the bed by the end of the 20th session.
Some concepts from social-educational family assistance also correspond to such a phase system: the getting-acquainted phase, the work phase, the leave-taking phase. This reflects how important it is in such invasive services to establish trust – and how important it is to prepare for ending the relationship, to say good-bye and regain autonomy. Many solution-oriented authors would curse this kind of approach. Instead, they suggest sticking closely to the envisioned solution, based on the experience that a successful solution to the problem will spawn further ones. Steve de Shazer even warns expressly not to concentrate on supposed deeper themes: “If it ain’t broke, don’t fix it” (1997, personal communication). Hargens (2004, p. 102) expresses the sentiment that resource-oriented work means that every session is always the first session. Change is unavoidable, something to keep in mind in “every encounter with others (...): remember they have changed. The same is true for me – I, too, have changed.” He defines therapeutic work “as a sort of continual research into which expectations, opinions and presuppositions are most helpful in getting out of therapy what both – the client and the therapist – want to achieve” (2004, p. 30). “Every encounter contains the trio of joining, determining goals and sounding out how best to reach these goals” (p. 107). He also supports the basic notion that every theory and every behavior must be adapted to the individual who is to fill that theory or action with life. If life is so colorful and diverse, why even bother to define phases and differences? We see three main reasons for doing so: First, they serve to structure one’s own learning process as a counselor. They provide order and security in an otherwise overwhelming array of information and options. Second, phase or course models represent the substrates of much experience, and if we learn about what was effective in a great number of other cases, it will raise our own chances to be successful. Third, dealing critically with such models means comparing expe-
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riences and concepts in order to develop new hypotheses and (maybe) new variations of these models. Bateson speaks of the synthesis of relaxed (creative) and stringent (organizing) thought patterns as the prerequisite for gaining insight (2000, pp. 117 ff.). In this sense we would like to offer a few ideas that have proved useful in our own practice. They are culled from the previous chapters based on many case examples, so a short list will suffice. Phases based on content: Schmidt (2010, pp. 123 ff.) suggests a phase model based on content to gain orientation and to plan the intervention: 1. Determine the context that led the client to seek counseling. 2. Negotiate a contract and set up a cooperation that will lead to a solution. 3. Develop goals. 4. Focus on exceptions and on experienced solutions. 5. Compare problem and solution patterns, and compare the various consequences of these patterns. 6. Perhaps introduce ambivalence coaching and renewed goal development. 7. Develop and agree on clearly verifiable steps to be taken. 8. Evaluate. 9. Stage a celebrated or ritualized end. Small steps – big steps: Counseling serves to create solution competence. And nothing is as effective as success one has experienced firsthand. Thus, the art of systemic counseling lies in constructing small, solvable problems from large, difficult problem complexes. This is especially important and useful at the beginning. In our cooperation with the client we develop small manageable steps and trust that success will motivate the client to take larger and more difficult steps. Symptom utilization and vehicle development: This means attacking the client’s most important problems. We choose one that will easily lead to success and is also suited for reflecting positively (even if only metaphorically – pars pro toto) on other problematic areas, for example, the children’s going to bed as a vehicle for how the parents agree on disciplinary measures or how the day is structured as a way to organize everyday structures in life or getting up in the morning as a way to learn how to fulfill duties. Giving some space: Systemic interventions take time to work, and any changes must take place in the everyday life of the client. For this reason we recommend that systemic counseling sessions take place every 2 to 4 weeks to give the clients time to integrate new things, to try them out and to collect new experiences. In inpatient or high frequency outpatient care situations, intensive interventions must be scheduled accordingly, i.e., don’t do sculptures or circular questions twice a week, but rather create a balance between invasive interventions and support in questions of everyday life. Melting the iceberg from the top down: Working through difficult matters demands a good, trustful relationship that has the potential to grow, even if the ice
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does melt very rapidly with some clients. It is best to assume that “presentable” problems are addressed at the beginning and the more “shameful,” painful or traumatic ones are reserved for later. Counselors should keep their eyes and ears open and give their clients some space. If work has been successful on the tip of the iceberg, if the problems found there have proved easily addressable, then one can proceed to deeper layers that can be dethawed and discussed.
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6 Positions, Values and Roles in the Systemic Trade
6 Positions, Values and Roles in the Systemic Trade
Our book has concentrated on depicting and imparting tools and methods. That may appear to suggest that systemic professionalism lies in applying these skills in an artful manner. However, we consider a solid ethical basis to our professional activities to be at least as important as any technical expertise and diligence. Now, at the end of this volume, we would like to present a few thoughts on this subject – well aware that we can only touch on the matter due to the limited space. The Ethics Guidelines of the German Association for Systemic Therapy and Family Therapy (DGSF) summarizes the basic attitude and values to be included in systemic counseling as follows (http://www.dgsf.org/dgsf/gremien/ethikrichtlinien.htm/ view): “The basic attitude of systemic counselors, therapists, supervisors and teachers of continuing education is characterized by respect, esteem and appreciation for both individuals and systems. This includes accepting individuals as persons and accepting one’s own multipartiality toward all persons in a system, independent of their age, sex, ethnic background, culture, status, sexual orientation, worldview and religion. Clients are viewed as the experts on their own lives and ways of life. They are encouraged to discover and use their resources autonomously; the counselor supports and accompanies them on this journey. Counselors and therapists should orient their actions to expanding the possibilities of the clients and their systems, and to supporting their self-organization. In particular, they should approach themes that touch on matters of gender sensitively. Their own premises should be constantly reflected upon. The rule for providing counseling and therapy is: As short as possible, as long as necessary.” This corresponds, in large part, with our own understanding of ethical counseling. In our further comments we refer explicitly to remarks made by Johannes Herwig-Lempp in a lecture given in Hanau on aspects of systemic anthropology (2005, personal communication) as well as to writings by Rotthaus (1989) and De Jong and Berg (2012). 6.1 PositionsandValues
6.1 Positions and Values The ethics of systemic therapy are rooted first in systemic paradigms and second in general, well-accepted ethical standards and societal norms of relevance to our discipline. The following aspects of a systemic anthropology are based on those expounded by Herwig-Lempp (2005, personal communication): 1. “Humans are self-willed” – they give events their own meaning, they draw their own conclusions and they adjust their behavior accordingly.
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2. “Through others we become ourselves” (Martin Buber). To the above characterization of humans as autonomous systems one must add the extension, in the sense of a twofold description (Rotthaus, 1989, p. 12), that humans become humans only through their interaction with others, with a social context, and that we as individuals are always part of a larger system. 3. Humans are in a state of continuous change. They change their standpoint and, depending on the context, their thoughts, feelings and behaviors. 4. Humans have almost unlimited resources and potentials for shaping the path of their life and solving their problems. 5. Humans construct their own truths and their own realities, and no one can claim “ownership” of the one, objective truth. If we take these thoughts seriously, then they will directly affect our professional approach: 1. “Humans are self-willed”: This sentence, which comprises the concepts of autopoiesis and self-organization, points to the fact that we can influence the way our clients think and act, but we cannot determine it. Rather, they always remain the pilots of their own lives and decide willfully and independently how to use or utilize any interventions, invitations or ideas we may impart on them. For us as practitioners this means dealing with clients with respect for their autonomy and for their ability to make their own decisions. In some cases, this may even mean accepting someone’s decision to cast aside all my professional offers and not to implement my well-intentioned behavioral suggestions. During counseling we consider the client the expert on his or her own life by adjusting the process to the desires and goals of the client and by continually checking together with the client what still fits and what doesn’t. 2. “Through others we become ourselves” (Martin Buber): The insight that humans are bound up in specific contexts and can only become real humans by participating in communication with others leads to the demand that we remain impartial and socially neutral when working with systems. When carrying out interventions we must always be reminded of the consequences they have for a client’s context and thus recursively, for our clients as well. That does not mean we should not take a stand for the protection of a child or support an employee in securing her rights in a company. It does, however, demand of us that we proceed with much understanding and empathy for the standpoint of everyone else involved and reflect about how they will react to our interventions, and which procedure will provide them with the most options for change. 3. Humans are in a state of continuous change. They change their standpoint and, depending on the context, their thoughts, feelings and behaviors: We always assume that we will be able to discover the fluctuations and variations that signal the ups and downs of life, even in clients who appear downright hypnotized by their problem and see only the unchangeable aspects of their daily lives. We watch out for such fluctuations, we pay attention to the different
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behaviors our clients exhibit in different contexts and use what we learn for the desired change process. This is best approached as a well-meaning, interested researcher who, together with the client, sets out to explore those hidden areas of life where things do succeed. 4. Humans have almost unlimited resources and potential: For difficult processes of change to succeed, the client must be clearly aware of this truth, and it is one that, together with its opposite, can be empirically proved through self-reflection: The more we concentrate on deficits, the more deficits we will discover – and the more we become convinced that we possess resources, the easier we can find some to work with. Here is where method and attitude cross trails. But to propound these opinions with any authority, our words must be backed by a professional learning process. In our experience this authenticity, this meeting of inner demeanor and applied method, determines the effectiveness of our interventions. With this attitude we can fearlessly accompany clients through the jungle of their problems and discover many a beautiful vista on the horizon, flowers along the way, hidden forks in the road, valuable plants and mighty trees. We can show all this to our clients and encourage them to strive to see more. It is sometimes said that everyone already has the resources in them to solve their problems. We are a bit more conservative and say that we assume that humans have the potential to develop the necessary resources. Some of our clients failed to have the proper learning experiences in their previous lives, so it is helpful for them to “catch up” on these resources later. Systemic intervention also means providing the proper framework for learning. The following quote illustrates this basic position very well: “If we fail to look at someone and see the beauty in that person, then we cannot give him anything. You do not help a person by discovering what about him is wrong, ugly or distorted. (. . .) Each of us is an image of God, but each of us resembles a damaged image. If we were to come upon an iconic figure that had been damaged by use, human hate or some other circumstance, we would still view it with reverence, fondness and sadness. We would not concentrate our attention solely on the fact that it is damaged, but on the tragedy that has led to its being damaged. We would concentrate on what remains of the beauty and not on what thereof has been lost. And that is what we must learn to do with every single human being . . .” (Anthony Bloom, a Russian-Orthodox monk, retrieved from www.sturzbecher.de/download/Vortrag-070905-Hannover.ppt). 5. Humans construct their own truths and their own realities, and no one can claim “ownership” of the one objective truth: This sentence is a plea for a respectful and curious humility toward clients, their worldview, their experiences, their conclusions and their decisions. However, it also assigns more responsibility to the decisions and behaviors of the individual. If I cannot call on some objective truth to justify my actions, then I have the responsibility to clearly substantiate my behavior. The same is true for my clients. We as counselors leave the responsibility for their life to them: We explore with them the
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background, the effects and the consequences of their actions, we sometimes give their firmly established convictions a little shake and provide new ideas and impulses. And we are curious as to which of them they take up, how they will implement them and what the result will be. Especially the latter step requires curiosity and respect on our part, in order for us to be able to watch the autonomous developmental processes our clients go through with open eyes and ears and determine how to use these insights in subsequent work. This approach is also valid when working with colleagues. Professional discussions sometimes turn into polarizing disputes about the “right,” and “wrong” ways of doing things, with each party selectively contributing only evidence supporting its own position. It is much more rewarding to start from the assumption that, similar to human eyesight, depth of vision is only achieved by comparing two different images. This requires us to be aware that our own habits, values and opinions flow into each and every observation we make – and that our own point of view can only grasp a part of the whole. Greater reliability is reached by looking at things from many different perspectives. In particular, when discussing case examples, this means putting the many different hypotheses next to each other on the table, viewing them as parallel approaches, in order to reach a common basis or to discover contradictions – or to determine how the controversial positions might be shaped into a common approach. Value-based opinions as a basis for professional dealings do not come by reading books or testing methods. Rather, it is necessary to wrestle with ethical questions during systemic training under the supervision of professional tutors. Additionally, we must face our own biographical truths. The latter is a point of contention: Does systemic training consist only of learning the proper methods or must is also include self-awareness and self-reflexion? In our opinion, a value-based systemic practice cannot exist without thorough selfreflexion. That is indeed the “hand that holds the tool” (see the Preface) – the person who uses a specific method. Every practitioner introduces into therapy his or her own perspectives, values, opinions and habits. There are those who prefer to mediate and deflate when things get loud, and there are those who like their disputes fought hard and boisterously. Some hear the grass growing and intervene at the slightest sign of a problem, whereas others sit by and trust in the “self-organization of the system,” overlooking all alarm signals. We must become conscious of such individual differences through self-experience. Only then can we use any existing strengths and offset the weaknesses by carefully attending to them. But self-experience has many other useful effects as well: – One’s own personal “blindspots” emerge, reducing the probability of their becoming part of the system’s problem. The helper gains some distance and can better recognize any previously hidden areas in systems. – Self-experience in family reconstructions is especially valuable as it offers many insights into family stories with their enormous treasure chest of tried and tested
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solutions. It widens one’s perspective and makes it easier to respect different life decisions by creating an understanding for the challenges and solutions families face. And it provides numerous valuable ideas about how families can master their life. Particularly being a stand-in in sculptures and role-plays provides insight and empathy toward the lives of very different generations and life circumstances. Expanding one’s perspectives as described above also expands the space in which hypotheses can be offered and limits the danger of labeling clients with standard diagnoses. Being able to empathize with and understand the various problems in a system allows joining and guarantees access to “difficult clients.” Once we have experienced what some interventions feel like, we will have a better understanding of the modes of action of these methods – and we will probably better understand why clients are reluctant to take up one method or the other. A very important effect of self-experience seems to us to be that it prevents burnout processes. The knowledge won by becoming aware of one’s own motives and vulnerabilities generally makes working with clients easier. It provides us some space and gives us a warning when we are becoming too involved in certain issues.
Case example: A female teacher who had experienced violence in her own life may not initially be excited about working with violent systems, since it may lead her to become overinvolved and overloaded. The physician who has seen his own brother become an alcoholic and feels responsible for it will be prone to suggest naïve rescue operations in similar professional constellations.
Dealing mindfully with our own feelings means working in such contexts that allow us to best develop our strengths, and removing ourselves, either temporarily or permanently, from situations that touch our sore spots or installing sound collegial support. 6.2 Control
6.2 Control In therapeutic contexts – regardless of the theoretical orientation – there are two basic prerequisites to gaining a client’s trust and thus setting the stage for open communication: The client must be there of his or her own free will and the therapist must commit to confidentiality. Systemic therapy often goes even further: Based on the concepts of autopoiesis (Maturana & Varela, 1992), the autonomy of the client is considered of paramount importance. Kurt Ludewig (1991) said it as follows: “The client determines the goal of therapy in dialog with the therapist; the goal of therapy is not determined from without.” Such a “clean” break between therapy and social control is debatable with respect to therapy as such (discussed in more detail in Russinger & Wagner, 1999). On the one hand, therapy often takes place in contexts in which the free will of the client is more or less limited, for example, in forensic psychiatric set-
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tings. On the other hand, even in therapy “in the field” voluntary participation is often more myth than truth – at the least only a relative truth: The husband who comes to counseling after being pressured by his wife may have to deal with the consequences of not changing his behavior; the employee who begins drug therapy to satisfy his employer is facing the loss of a job; the client sent by his family physician will only grudgingly accept the fact that he has to take unusual means to solve or mitigate his problem. In these cases the amount of free will and selfmotivation involved in the decision to attend psychotherapy varies greatly, and yet they all need well-formulated invitations in order to migrate from being “forced visitors” to “customers” (see Chapter 4.1.6). In other psychosocial contexts, where the goal is to effect change in human systems, this differentiation is even less possible: in the Youth Services Office, in the workshop for the handicapped, in inpatient youth assistance, in family assistance – everywhere tasks of supervision or control are carried out by the same people bestowed with the mandate of encouraging people to develop or change their previous behavior. This is only rarely discussed in systemic literature – even in the literature on systemic social work (exceptions: Rotthaus, 1994; Pleyer, 1996; Conen, 1999, 2011; Russinger & Wagner, 1999; Berg & Kelly 2000). Conen (1999) sees this matter embedded in the “background of our German history,” where “authority and power were abused to an extent never before observed.” We believe a further reason to be the therapeutization of many social fields, coupled with the higher status associated with all things therapeutic – and the disdain for areas where social control is exercised over involuntary clients. A classic example may be seen in the difference of social status between child guidance or counseling centers on the one side and Youth Services or closed-ward institutions for adolescents on the other. This difference is also reflected in the respective wages (but is in no way related to the pressures and responsibilities one must take on). The unpopular task of exercising coercion and control is something one would rather leave to others who will not dirty the nest of therapy. Coercion and control just don’t seem to suit the concepts of autopoiesis and respect for the client – the highest paradigms of systemic thought. Discussions crop up again and again in training contexts about how we can best confront and, in fact, dissolve this contradiction: how we can work systemically in a coercive atmosphere. The problem in practice is not that trainees are in conflict with inner epistemological contradictions. Rather, the problems are often more mundane: The counselor shies away from confronting such a client or pointing out the obvious consequences of the client’s behavior. Perhaps they have never learned how to confront someone with such truths, perhaps they are afraid of the client’s reaction, perhaps such a strategy just doesn’t fit their own personality. Or they are afraid of jeopardizing the trust they have built up or of never being able to build up such trust. Case example: In a group for continuing education the head of a nursery school reports about a difficult conversation she had with some parents who had repeatedly broken the rules and made life difficult for their child. Despite several discussions no solution emerges, and various solution strategies have been acted out in role-playing scenarios. It soon be-
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comes clear that she is voicing her wishes for change very cautiously, appealing to the parents’ reason, even though she has resigned to the fact that it is useless and is building up steam that she is too timid to vent. When the others in the group suggest that she become more open and clear with her stance and determine – and name – specific consequences for the next time that the parents don’t give in, she is terrified: That sounds rather harsh. During role-play, she is told that pressure to react is only now emerging, and that each of the previous discussions was experienced as just another aimless pedagogical attempt. But she remains worried that the trust between her and the parents will suffer. We ask whether she has children of her own, which she does, so we ask whether the relationship to her children could be considered trustful, to which she also agrees. At our third question she smiles: “Don’t you sometimes set limits and explain the consequences for your own children when they don’t follow the rules? And does that destroy your relationship of trust?”
A good relationship between parents and children always means combining care and control, fostering and rigor, without putting trust at risk (though it may sometimes provoke strong reactions of displeasure or resistance). Some may argue that this has more to do with upbringing than therapy, but that is only semantic: In practical psychosocial work these two types of behavior are often combined. It would seem to us to be more useful, instead of strictly separating these forms, to develop a conscious stance toward control and pressure and to determine for oneself a transparent and ethically substantiated set of tools at one’s disposal. The first step in this direction is to see the positive sides of exerting pressure and control in the psychosocial disciplines: – Situations involving coercion often form the necessary framework for clients to even consider being helped. They bring the practitioner and the helper together in one spot and give them the chance to effect change in new ways and to reduce the necessity for state control/intervention. – Pressure and control can get a system going, forcing clients to deal with parts of their life they have previously tried to ignore. This is a task particularly well-suited for systemic methods: Focusing on strengths and resources doesn’t mean siding with any tendencies within the system to avoid or deny reality. We must always address violations of social or ethical rules in client systems. That demands courage and an artful approach to ensure the necessary respect. – Concepts of autopoiesis are blind to matters of power asymmetry in systems. Dependence, repression and exploitation are only constructs, but ones that are closely aligned with our value system. We need to be able to limit things, in order to constrain the abuse of power in client systems. In cases of sexual abuse of children we cannot and should not hope for the autopoietic powers in the family and resort only to slight “disturbances” of the old order. Rather, we must intervene and (re)establish security and protection. When determining how a system will see and react to various forms of intervention, our systemic concepts can be very useful and provide orientation. – Quarreling with someone, confronting someone, restraining someone – these are also signs that we care about that person, that the matter is important to us, that we are interested and engaged. Many clients from social services come from
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families where commitment and security were not consistent values. It is our experience that, following a certain period of resistance, most relationships with clients become more intense and better if clear limits have been set, or control has been exercised in a respectful and interest manner. Often clients later even express how important and helpful our efforts were. To best deal with these delicate matters and to avoid being indiscriminate, there are a number of requirements: – The best path is reached via self-experience. One must be able to recognize one’s own patterns arising from past experiences of power, pressure and control. Where have we experienced a fear of confrontation? When have we shied away from such situations? Especially if confrontation has been a taboo subject, one risks becoming arbitrariness or overreacting. We must know our own desires for power in order to deal adequately and consciously with matters of power. – We must have a proper methodological toolkit at our disposal. How to best confront the client while maintaining respect for the client’s self-determination? Some examples of helpful questions are: If you decide not to take up my offer, what consequences would that decision have for you? How do you see the chances of our succeeding despite the forced nature of our relationship? What’s in it for you? What do you want and what will you do? – Even under circumstances of force, the goal remains to expand the client’s opportunities. We should assume that clients who do not come of their own free will nevertheless have their own reasons for wanting to change their way of life. And it is these parts of that person or system that we latch onto. The violent father didn’t know better or was trying to find a way to be a loving father to his children; the neglecting mother longs to have order return to her life and to give her children a normal home and loving care. – We think it is especially important to maintain open communication with other colleagues, to exchange information and experiences. If we feel compelled to intervene with all due force in a system, we need companions to help us go down that path, to encourage us and, if need be, to correct our actions. Such relationships presume an open atmosphere of mutual support and critique. If we know, for example, that families are not attending counseling of their free will, then it is important to discuss this with them and to show them how important it is that they have taken the step to find a solution. Such clients will initially experience our support as coercion, too, but in fact they are making a much more positive decision – to save their family, – to prevent their children being placed in other families or facilities, – to prevent the family from being torn apart, – to eventually come back together as a family. That is a positive decision the family has made. The “authorities” may have forced them to participate in a “sanction,” but their act of freedom lies in deciding how
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they want to live in the future. The fact that they have, grudgingly and unenthusiastically, accepted help is a sign of their tenacity. Sometimes freedom means accepting what cannot be avoided. That a family nevertheless embraces such “forced” decisions shows that they truly do see the necessity of the sanction. This is the family’s accomplishment, and the expression of their freedom to act. We could, and indeed always should honor this competence despite all other signs of resistance. We should mention it repeatedly and never cease to emphasize that we understand and can appreciate their acting under coercion, and that they are showing great freedom and insight by deciding to act as they have. Part of this act also means accepting our own role as the controller, as the agent of the state who is capping the rights of a citizen. We need to clearly express and advocate – what is expected of whom – from the client, from the helper, from other persons involved; – who will be doing the controlling and the reporting when and how. In our experience, ignoring or hushing up the fact of coercion does not create a solid basis for such “involuntary helping.” Rather, it is better to put everything out in the open and clearly define the initial situation. 6.3 TheRolesoftheCounselor:Teacher,Facilitator,Consultant,Evaluator
6.3 The Roles of the Counselor: Teacher, Facilitator, Consultant, Evaluator In light of the multitude of situations, people and problems with which we are confronted, it is no wonder that systemic therapy reflects this great variety. The descriptions of methods given in the previous chapters demand that the counselor assume many different roles and show the upmost flexibility. Antony Williams (1995) summarized this state of affairs for supervision by describing four different roles. We consider these four dimensions to be very helpful for envisioning the roles taken in a systemic intervention. Williams says that, depending on the situation, supervisors can – teach, mediate, inform → “teacher”; – listen, discharge, resolve feelings, find space for self-discovery → “facilitator”; – encourage clients and systems to explore their own viewpoints and perceptions and to draw their own conclusions → “consultant”; – provide feedback on own perceptions and judgments, review and evaluate goals → “evaluator.”
6.3.1 Teacher In many situations one can best assist the clients by being their teacher. This means imparting information, explaining relationships, making suggestions for behavior, giving them the necessary space to try out new behaviors, initiating
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learning processes. A good teacher does this with much systemic-constructivist respect for the self-organization of the system. Respect does not meaning keeping all our ideas and experiences to ourselves in order not to dampen any autopoietic constructions. Yet we should not impose them on the clients either. Case example: Traumatized clients find it helpful to receive information about the consequences of trauma. This helps them to better assess their own experiences and behavior, and to understand them as “normal reactions to an abnormal situation.” Case example: Bereaved persons are relieved to hear that a normal grieving reaction has many phases. Of course, they will continue to grieve, but the cognitive framework presented to them provides support for their extremely fragile state. The counselor can offer some tips for better coping with feelings of panic or anxiety. Case example: Parents find it helpful to obtain straightforward information about the various developmental phases of children or about their eating and sleeping habits. Violenceprone adolescents can profit from practicing alternative behaviors under the supervision of a coach. Today we know that psychoeducation can be a very effective method of intervention for a number of syndromes (sleeping disorders, borderline disorders, etc.). Reframings also have an educational aspect to them.
6.3.2 Facilitator Sometimes it helps clients if we just listen to them, hear their stories, be there for them, support them emotionally and provide emotional relief. This helps clients by showing that someone takes them seriously, and it creates the space necessary for them to explore their own feelings, entanglements and behavioral patterns. In client-centered psychotherapy this role has been precisely charted, and there is much evidence supporting its efficacy. Systemic counseling, too, has adopted this role as its basic approach, for example in the form of joining, which has proved useful in many counseling situations. Case example: The adolescent in the residential group needs someone to talk to: Things aren’t going very well in school these days, and she’s been fighting with her best friend nonstop. She doesn’t need any lectures, well-meant suggestions, reframings, sculpture work or circular questions – she just needs someone to sit there and hear her out. Case example: The section for organizational development in a company was having a bad stretch. The staff needed some space to talk about their woes. After an hour’s time there were still no concrete solutions, no defined goals, no pertinent strategies. But the air had cleared somewhat, and everyone seemed more optimistic and confident. Some even said that they had felt very isolated and lonely, and that it had been a good thing to hear that others had had the same experience.
This role can be useful if clients are trying to turn us into listeners to their complaints and not helpers to induce change in their lives. If we took any role other than facilitator we would be working without the client’s mandate. Clients who like to complain are rarely open to self-exploration (see the role of consultant
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below). Providing feedback without their wishing to hear it or accept it is rarely welcomed (see the role of evaluator below). Providing explanations about which solutions are available (see role of teacher above) is often rejoined by the complainer by noting that the suggested solution wouldn’t work anyway because it’s already been tried previously (without success, of course) or because the situation in this particular case is different. The complainer will always maintain the position of being the victim of his or her situation. However, after a few sessions in the role of facilitator one can often discuss with the client whether there might be a mandate there somewhere, turning the complainer – in the end – into a customer sensu Steve de Shazer. In many situations is it wise to have the role of facilitator in one’s counseling toolbox. Some people in crisis initially just need a sympathetic ear to eventually gear up to dealing with change. The modern zeitgeist of counseling, however, usually comes from a very different corner. Brilliant techniques, interventions and miracle questions, methods inducing trances and other states of mind are employed to activate client systems to quickly move toward change – a sign of our fast and efficient times with a need to save both time and money. Being an emotional “dumping ground” or simply listening to “depressive regurgitation” is not the popular thing to do. Still – in times of crisis people need other people, patience and a sympathetic ear. For everyone in a hurry, a word of consolation that goes back to Bertolt Brecht: The shortest connection between two points is sometimes the detour.
6.3.3 Consultant This role summarizes what most people think of when they hear the term “systemic counseling.” We sound out contexts and present them visually or spatially. We use circular questions, questions oriented to the future or to a particular solution. We work with genograms, timelines or sculptures. We generate new perspectives and new behaviors, and encourage taking responsible actions. The consultant suggests structures and ways of shaping the sessions which allow the clients to discover their own points of view, a new or unusual context or an option for the future. The consultant consults without expectations of a particular result. The consultant does not provide advice as a teacher would. Rather, the consultant offers a buffet of conversation types that serve to stimulate the client system to develop its own solutions, viewpoints and action options.
6.3.4 Evaluator The evaluator introduces his or her own point of view into what is happening. The evaluator provides feedback, be it direct reflections on what is going on in the situation or in the client system.
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Case example: The social-educational family counselor is speaking with a client family: “I have the impression, Ms. Müller, that you’ve been withdrawing yourself from the discussion in the family ever since we began talking about your son moving out.” Case example: In a team supervision session the supervisor says: “I have the impression that there’s a lot of tension in the air today. Do you get that feeling, too?”
But feedback not only reflects one’s own perceptions of the situation or the system, it can also contain judgments. Case example: During the counseling of parents: “It seems to me your way of dealing with your son Peter is not very consistent. Here, talking to me, you support setting limits, but at home you are clearly not setting proper limits, but rather always making exceptions whenever Peter breaks the rules.” Case example: During the supervision of a team: “During the last session we all agreed that you would not talk among yourselves about the criticism expressed toward your colleague Ms. Schulze. Rather, everyone was to express his or her criticism directly toward her. But now I see that you haven’t stuck to the agreement. How are we going to deal with this?” Case example: During intensive individual counseling of an adolescent: “You have endangered yourself in the past few days to such an extent that I can’t keep quiet any longer. I am considering making an appointment for a meeting with your parents, your caseworker in Social Services and yourself to try and determine together how we are going to deal with the present situation.”
This particular role may be difficult for many systemic counselors to accept since it means voicing judgment. This would seem to contradict the basic constructivist approach of systemic thought. But such behavior may have an even stronger catch to it: Whenever we judge, we assume responsibility and put ourselves above our clients. This makes us vulnerable to resistance. That is not very popular among counselors, and yet every bit of human perception – even that of counselors – is necessarily connected to some internal judgment. Similarly, clients of particularly resource-oriented, neutral counselors may ruminate over questions like: “Does he really mean that? Why won’t he give me any critical feedback? He’s overlooking my weaknesses – can I still trust his praise or is all of it just some technique he learned?” Approval is most effective when counselors have the guts to give their clients critical feedback when discussing how far they’ve come toward their goals and where there are still deficits. It is most authentic when counselors can mention both strengths and weaknesses and openly confront clients with areas in which they have violated important norms or missed self-imposed goals. Many clients have a very keen set of senses and grasp their counselor’s moods accurately and quickly. They are confused if the counselor tries to cover up his own reactions or emotions and acts as if neutral and relaxed. Not only does such an attempt to suppress feelings and express neutrality torture the counselor and represent an impossible, inhuman goal, it can actually be damaging to clients because it places them in contexts where what is said and what is felt do not match. It is better for both parties for the counselor to remain authentic, to
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show and discuss own feelings, and to work through what that means directly with the client. Especially when working with adolescents such roles are important because they demand clarity of behavior, whether verbal or actual. Such a “statement” may provide the orientation or grounding necessary to develop one’s own approach by delimiting oneself and interacting with one’s environment. But the evaluator does not express only criticism. In Chapter 5.11.2 we described what we called “cheerleading.” By emphasizing the successes, the good performance or the progress made by a client system we are also playing the role of the evaluator. We give feedback about our positive perceptions and about the client’s resources. Of all the roles described above, none is per se better than the rest. Rather, each has its own place in our work with clients. The goal (and the art!) is to recognize these four roles in our dealings with a system and to implement them properly. We need to know – what role we are presently playing in the client system, – when we have switched roles, – why we chose one role for intervening in a particular system and another role for another system, – why some clients almost beg us to remain in a particular role and cannot imagine our assuming any other role in the system, – what our choice of role has to do with us, with our particular sensitivity, our experiences and our fears when working with the system in question. It has proven very productive to work with these four roles when evaluating the sessions of a client system. One can, for example, make a log of – how much of the time one was in what role, – whether the course was typical for one’s work or specific to the respective client system, – whether one chose the specific role for the topic being discussed during the session or – whether one generally likes a particular role and tends to get “stuck” in it in (nearly) all sessions, – when one spontaneously switched roles and what motives there may have been to do so. Of course, there are many other possible questions – these are just a few examples and suggestions on how to use this model to evaluate counseling situations. Variety means choices, but a multitude of choices can also be confusing or even frightening. Sometimes it’s better to know exactly where things are going. Systemic counseling feeds off variety: of methods, of mentalities, of counseling strategies, of personalities to realize all this. But two basic positions are central prerequisites to the constructive use of such variety: 1. The pleasure and curiosity at discovering something new with every single system, with every single client: discovering what method works best, what per-
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spectives best lead to change. Remaining curious despite one’s breadth of experience and despite one’s cumulative clinical and therapeutic knowledge – that is the challenge. 2. The pleasure and curiosity to ever re-discover what perspectives can provide me, the counselor, with something seminal to my work: which methods are best suited for my work, which ones help me most to succeed, which one make me feel authentic. The first attitude mentioned above helps us to work effectively; the second helps us to have a long and gratifying professional life. And that both are recursively bound to each other is clear to anyone who adopts the systemic approach.
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References
References
References
Aarts, M. (2009): Marte Meo, ein Handbuch. Harderwijk. Altmeyer, S.; Kröger, F. (2003): Theorie und Praxis der Systemischen Familienmedizin. Göttingen. Andersen, T. (1991): The Reflecting Team: Dialogues and Dialogues about the Dialogues. New York. Anderson, H.; Goolishian, H. (1990): Menschliche Systeme als sprachliche Systeme. Familiendynamik 15 (3): 212–242. Anderson, H.; Goolishian, H. (1992): The client is the expert: A not-knowing approach to therapy. In: McNamee, S. & Gergen, K. (Eds.): Social Construction and the Therapeutic Process. Newbury Park. Antonovsky, A. (1987): Unraveling the Mystery of Health – How People Manage Stress and Stay Well. San Francisco. Bastine, R.; Fiedler, P.; Grawe, K.; Schmidtchen, S.; Sommer, G. (1982): Grundbegriffe der Psychotherapie. Weinheim. Bateson, G. (2000): Steps to an Ecology of Mind: Collected Essays in Anthropology, Psychiatry, Evolution and Epistemology. Chicago. Bayerisches Landesjugendamt (2005): Sozialpädagogische Diagnose. München. Bayerisches Landesjugendamt (2005): Hilfeplan: Aufstellung, Mitwirkung, Zusammenarbeit. München. Berg, I. K.; Kelly, S. (2000): Building Solutions in Child Protective Services. New York. Berger, M.; Spanjaard, H. (1996): Families First. Utrecht. Boeckhorst, F. (1988): Strategische Familientherapie. Dortmund. Boelicke, T. (2004): Kognitive Lebenszielanalyse in Therapie und Beratung. Verhaltenstherapie und psychosoziale Praxis 36 (2): 313–324. Bohm, D. (2004): On Dialogue. New York. Boscolo, L.; Bertrando, P. (1993): The Times of Time: A New Perspective in Systemic Therapy and Consultation. New York. Boscolo, L.; Cecchin, G.; Hoffmann, L.; Penn, P. (1987): Milan Systemic Family Therapy: Conversations in Theory and Practice. New York. Boszormenyi-Nagy, I. (1985): Intensive Family Therapy. Theoretical and Practical Aspects. New York. Bradford, L. P.; Gibb, J. R.; Benne, K. D. (1964): T-Group Theory and Laboratory Method Innovations in Re-Education. Hoboken. Brem-Gräser, L. (2011): Familie in Tieren: Die Familiensituation im Spiegel der Kinderzeichnung. Entwicklung eines Testverfahrens. München. Buggenthin, U. (2005): Sozialpädagogische Familienhilfe. In: Ritscher, W. (Hg.): Systemische Kinder- und Jugendhilfe. Heidelberg, 217–235. Bünder, P. (1998): Video-Training. Eine neue Methode innerhalb der Sozialarbeit, dar-
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
322
References
gestellt am Beispiel der MarteMeo-Methode. In: Mrochen, S.; Berchtold, E.; Hesse, A. (Hg.): Standortbestimmung sozialpädagogischer und sozialarbeiterischer Methoden. Weinheim, 83–103. Bünder, P.; Helfer, A.; Sirringhaus-Bünder, A. (2005): Praxisbuch Marte Meo. Köln. Carter, B.; McGoldrick, M. (1989): The Changing Family Life Cycle: A Framework for Family Therapy. Boston. Cierpka, M. (2008): Handbuch der Familiendiagnostik. Berlin. Conen, M.-L. (Hg.) (1992): Familienorientierung als Grundhaltung in der stationären Erziehungshilfe. Dortmund. Conen, M.-L. (1999): “Unfreiwilligkeit” – ein Lösungsverhalten. Zwangskontexte und systemische Therapie und Beratung. Familiendynamik 24 (3): 292–297. Conen, M.-L. (2011): Wo keine Hoffnung ist, muss man sie erfinden. Aufsuchende Familientherapie. Heidelberg. Covey, S. (2004): The Seven Habits of Highly Effective People. New York. De Jong, P.; Berg, I. K. (2012): Interviewing for Solutions. Stamford. de Shazer, S. (1980): Putting Difference to Work. New York. de Shazer, S. (1985): Keys to Solution in Brief Therapy. New York. de Shazer, S. (1992): Dem Klienten zuhören – ein Interview mit Steve de Shazer. Geführt von Thomas Keller und Roswitha Schug. Zeitschrift für systemische Therapie 10 (4): 279–287. de Shazer, S. (1994): Words Were Originally Magic. New York. Duhl, F.; Kantor, D.; Duhl, B. (1973): Learning, Space and Action in Family Therapy: A Primer of Sculpture. In: Bloch, D. (Ed.): Techniques of Family Psychotherapy. New York, 47–63. Durrant, M. (1993): Residential Treatment: A Cooperative, Competency-Based Approach to Therapy and Program Design. New York. Eggemann-Dann, H.-W. (2004): Externalisierung am Beispiel des Familienbrettes als stützende Intervention bei unvollständigen Familien und im Trennungsprozess. Unveröffentlichtes Seminarhandout. Hanau. Eggemann-Dann, H.-W. (2005): Situationskompetenz als Qualifizierungsziel in den Hilfen zur Erziehung (HzE). praxis im dialog. Zeitschrift des Praxis-Instituts für systemische Beratung: 9–16. Ellis, A.; Hoellen, B. (2004): Die rational-emotive Verhaltenstherapie. Stuttgart. Foerster, H. von (1984): On Constructing a Reality. In: Watzlawick, P. (Ed.): The Invented Reality: How Do We Know What We Believe We Know? (Contributions to Constructivism). New York, 41–62. Foerster, H. von; Pörksen, B. (2002): Understanding Systems: Conversations on Epistemology and Ethics. New York. Fryszer, A. (1995): Das Spiel bleibt Spass. Psychodrama 8 (2): 169–187. Fryszer, A. (2005): Leistungsdiversifikation in der Sozialarbeit und ihre Folgen für die sozialen Dienste. In: Fröse, M. (Ed.): Management Sozialer Organisationen. Berlin, 293–318. Fryszer, A. (2006): Psychodrama in der Arbeit mit Familien. In: Bosselmann R.; LüffeLeonardt, E.; Gellert, M. (Hg.): Variationen des Psychodramas. Meezen. Gammer, C. (1999): Phasische Familientherapie. In: Schneider, K. (Hg.): Familientherapie in der Sicht psychotherapeutischer Schulen. Paderborn, 110–133.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
323
References
Gammer, C. (2005): Kursausschreibung Systemische Therapie und Beratung. Wiesbaden. Girolstein, P. (2005): Elterncoaching nach Haim Omer. praxis im dialog. Zeitschrift des Praxis-Instituts für systemische Beratung: 17–22. Glasersfeld, E. von (2002): Radical Constructivism. A Way of Knowing and Learning. London. Glasl, F. (Hg.) (1983): Verwaltungsreform durch Organisationsentwicklung. Bern u. Stuttgart. Glasl, F.; Lievegoed, B. (1996): Dynamische Unternehmensentwicklung. Bern. Grawe, K. (1999): Wie kann Psychotherapie noch wirksamer werden? Verhaltenstherapie und psychosoziale Praxis 31 (2): 185–199. Grawe, K. (2000): Psychologische Therapie. Göttingen. Grawe, K. (2005): Interview: Ich bin kein Anhänger von Wahrheiten. Report Psychologie 7 (8): 304–308. Grawe, K.; Regli, G.; Smith, E.; Dick, A. (1999): Wirkfaktorenanalyse – ein Spektroskop für die Psychotherapie. Verhaltenstherapie und psychosoziale Praxis (31) 2: 201–225. Haken, H.; Schiepek, G. (2010): Synergetik in der Psychologie. Göttingen. Haley, J. (2007): Directive Family Therapy. Philadelphia. Hargens, J. (1989): KundIn, KundigE, KundschafterIn. Gedanken zur Grundlegung eines “helfenden” Zugangs. Zeitschrift für systemische Therapie 11 (1): 14–20. Hargens, J. (2004): Aller Anfang ist ein Anfang. Gestaltungsmöglichkeiten hilfreicher systemischer Gespräche. Göttingen. Hargens, J. (2006): Aller Anfang ist ein Anfang. Gestaltungsmöglichkeiten hilfreicher systemischer Gespräche. Göttingen. Hawellek, C.; Schlippe, A. von (Hg.) (2011): Entwicklung unterstützen, Unterstützung entwickeln. Systemisches Coaching nach dem Marte Meo Modell. Göttingen. Herwig-Lempp, J. (2001): Multiproblemfamilien. Kontext 32 (2): 160–161. Herwig-Lempp, J. (2002): Maschinen, Menschen, Möglichkeiten. Eine kleine Ideengeschichte des systemischen Arbeitens. Kontext (33) 3: 190–212. Herwig-Lempp, J. (2004): Die VIP-Karte – ein einfaches Instrument für die Systemische Sozialarbeit. Kontext 35 (4): 353–364. Herwig-Lempp, J. (2012): Ressourcenorientierte Teamarbeit. Systemische Praxis der kollegialen Beratung. Ein Lern- und Übungsbuch. Göttingen. Hillmeier, H. (2003): Sozialpädagogische Diagnose. Mitteilungsblatt des Bayerischen Landesjugendamtes Nr. 3. München. Hollstein-Brinkmann, H. (1993): Soziale Arbeit und Systemtheorien. Freiburg. Hollstein-Brinkmann, H.; Staub-Bernasconi, S. (2005): Systemtheorien im Vergleich: Was leisten Systemtheorien für die soziale Arbeit? Wiesbaden. Hosemann, W.; Geiling, W. (2005): Einführung in die systemische Soziale Arbeit. Freiburg. Hosemann, D.; Kriz, J.; Schlippe, A. von (Hg.) (1998): FamilientherapeutInnen im Gespräch. Freiburg. Hüther, G.; Rüther, E. (2010): Die nutzungsabhängige Reorganisation neuronaler Verschaltungsmuster im Verlauf psychotherapeutischer und psychopharmakologischer
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
324
References
Behandlungen. In: Schiepek, G. (Hg.): Neurobiologie der Psychotherapie. Stuttgart, 224–234. Imber-Black, E.; Roberts, J.; Whiting, R. (Eds.) (2003): Rituals in Families and Family Therapy. New York. Kast, V. (2002): Trauern. Freiburg. Kast, V. (2013): Sich einlassen und loslassen – Neue Lebensmöglichkeiten bei Trauer und Trennung. Freiburg. Kinney, J.; Haapala, D.; Booth, C. (1991): Keeping Families Together. The Homebuilders Model. New York. Klefbeck, J. (1998): Netzwerktherapie – Eine Behandlungsmethode in Krisen. In: Röhrle, B.; Sommer, G.; Nestmann, F. (Hg.): Netzwerkinterventionen. Tübingen, 139–152. Kos, M.; Biermann, G. (2002): Die verzauberte Familie. Ein tiefenpsychologischer Zeichentest. München. Kübler-Ross, E. (2008): On Death and Dying. Abingdon. Kunze, M. (1998): Interkulturelle Psychologische Beratung. Wege zum Menschen 50: 195–205. Laing, R. (1972): Knots. New York. Laing, R.; Phillipson, H.; Lee, A. (1966): Interpersonal Perception. New York. Lankton, S. R.; Lankton, C. H. (1989): Tales of Enchantment. Goal-Oriented Metaphors for Adults and Children in Therapy. New York. Laucht, M.; Schmidt, M. H.; Esser, G. (2000): Risiko- und Schutzfaktoren in der Entwicklung von Kindern und Jugendlichen. Frühförderung interdisziplinär 19 (3): 97–108. Lenk, W. (1988): Psychotherapeutische Behandlung eines Lipoms im Eigenversuch. Hypnose und Kognition 5 (1): 45–52. Lévi-Strauss, C. (1966): The Savage Mind. Chicago. Lévi-Strauss, C. (2012): Tristes Tropiques. London. Lewin, K. (1951): Field Theory in Social Science. New York. Lorenzer, A. (1983): Sprache, Lebenspraxis und szenisches Verstehen in der psychoanalytischen Therapie. Psyche 37 (2): 97–115. Lösel, F.; Bender, D. (2008): Von generellen Schutzfaktoren zu differentiellen protektiven Prozessen: Ergebnisse und Probleme der Resilienzforschung. In: Opp, G.; Fingerle, M.; Freytag, A. (Hg.): Was Kinder stärkt: Erziehung zwischen Risiko und Resilienz. München, 37–58. Ludewig, K. (1991): Vom Stellenwert diagnostischer Maßnahmen im systemischen Verständnis. In: Schiepek, G. (Hg.): Systeme erkennen Systeme. München, 155– 174. Ludewig, K. (1999): Die therapeutische Intervention – Eine signifikante Verstörung der Familienkohärenz im therapeutischen System. In: Schneider, K. (Hg.): Familientherapie in der Sicht psychotherapeutischer Schulen. Paderborn, 78–95. Ludewig, K.; Wilken, U. (Hg.) (2000): Das Familienbrett: Ein Verfahren für die Forschung und Praxis mit Familien und anderen sozialen Systemen. Göttingen. Luhmann, N. (2009): Soziologische Aufklärung. Wiesbaden. Madanes, C. (2002): Hinter dem Einwegspiegel. Salzhausen.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
325
References
Maturana, H.; Varela, F. (1992): Tree of Knowledge: Biological Roots of Human Understanding. Boston. McGoldrick, M.; Gerson, R. (1986): Genograms in Family Assessment. New York. Merl, H.; Korosa, H. (1981): Eine Modifikation der Familien-Skulptur. Partnerberatung 3: 146–154. Minuchin, S. (2012): Families and Family Therapy. Cambridge, Massachusetts. Minuchin, P.; Colapinto, J.; Minuchin, S. (2006): Working with Families of the Poor. New York. Minuchin, S.; Fishman, C. (1981): Family Therapy Techniques. Cambridge. Minuchin, S.; Lee, W. Y.; Simon, G. M. (1996): Mastering Family Therapy: Journeys of Growth and Transformation. New York. Minuchin, S.; Montalvo, B.; Guerney, B.; Rosman, B.; Schumer, F. (1967): Families of the Slums. New York. Minuchin, S.; Rosman, B.; Baker, L. (1978): Psychosomatic Families. Cambridge. Moreno, J. L. (1953): Who Shall Survive? Foundations of Sociometry, Group Psychotherapy and Sociodrama. New York. Moreno, J. L. (2001): Psychodrama und Soziometrie. Köln. Moreno, J. L. (2008): Gruppenpsychotherapie und Psychodrama. Stuttgart. Morgan, G. (2006): Images of Organization. Thousand Oaks. Mrochen, S.; Berchtold, E.; Hesse, A. (1998): Standortbestimmung sozialpädagogischer und sozialarbeiterischer Methoden. Weinheim. Müller, G. (2002): Thema mit Variationen: Strukturen und Prozeß der Skulpturtechnik. In: Moskau, G.; Müller, G. (Hg.): Virginia Satir. Wege zum Wachstum. Paderborn. Neumann, W. (2004): Das “Familienbrett” als methodisches Hilfsmittel bei der “Spurensuche als psychologische Erinnerungsarbeit”. Kontext 35 (3): 247–260. Omer, H.; Schlippe, A. von (2011): Autorität ohne Gewalt – Coaching für Eltern von Kindern mit Verhaltensproblemen. “Elterliche Präsenz” als systemisches Konzept. Göttingen. Omer, H.; Schlippe, A. von (2012): Autorität durch Beziehung. Die Praxis des gewaltlosen Widerstands in der Erziehung. Göttingen. Opp, G.; Fingerle, G.; Freytag, A. (2008): Was Kinder stärkt: Erziehung zwischen Risiko und Resilienz. München. Palmowski, W.; Thöne, E. (1995): Zirkuläres Fragen, was war das noch? Zeitschrift für systemische Therapie 13 (2): 111–120. Papp, P. (1976): Brief therapy with couples groups. In: Guerin, P. J. (Ed.): Family Therapy – Theory and Practice. New York, 350–364. Papp, P. (1977): Family Choreography. In: Guerin, P. J. (Ed.): Family Therapy – Theory and Practice. New York, 465–479. Papp, P. (1996): The Process of Change. New York. Peseschkian, N. (2007a): Positive Familientherapie. Eine Behandlungsmethode der Zukunft. Frankfurt a. M. Peseschkian, N. (2007b): Wenn du willst, was du noch nie gehabt hast, dann tu, was du noch nie getan hast. Freiburg. Peseschkian, N. (2012): Der Kaufmann und der Papagei. Frankfurt a. M. Pleyer, K.-H. (1996): Schöne Dialoge in häßlichen Spielen? Überlegungen zum Zwang als Rahmen für Therapie. Zeitschrift für systemische Therapie 14 (3): 186–196.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
326
References
Prior, M. (2012): MiniMax-Interventionen. Heidelberg. Reddemann, L. (2007): Eine Reise von 1000 Meilen beginnt mit dem ersten Schritt. Freiburg. Ritscher, W. (Hg.) (2005): Systemische Kinder- und Jugendhilfe. Heidelberg. Ritscher, W. (2012): Systemische Modelle für die soziale Arbeit. Heidelberg. Röhrle, B.; Sommer, G.; Nestmann, F. (1998): Netzwerkinterventionen. Tübingen. Rotthaus, W. (1989): Die Auswirkungen systemischen Denkens auf das Menschenbild des Therapeuten und seine therapeutische Arbeit. Praxis der Kinderpsychologie und Kinderpsychiatrie 38: 10–16. Rotthaus, W. (1994): Sexuelle Mißhandlung – Anmerkungen zur Konstruktion einer Welt der Verantwortlichkeit mit dem Täter. Zeitschrift für systemische Therapie 12 (1): 25–32. Russinger, U.; Wagner, E. (1999): Gewalt – Zwang – System. Systemisch-konstruktivistische Konzepte in institutionellen Zwangskontexten. Zeitschrift für systemische Therapie 17 (3): 144–156. Satir, V. (1988): Familienbehandlung. Freiburg. Satir, V. (1990): Peoplemaking. London. Satir, V.; Baldwin, M. (2008): Satir Step by Step: A Guide to Creating Change in Families. Palo Alto. Schiepek, G. (1991): Systeme erkennen Systeme. München. Schiepek, G. (Hg.) (2010): Neurobiologie der Psychotherapie. Stuttgart. Schiepek, G.; Kröger, F.; Eckert, H. (2001): Nichts ist praktischer als eine gute Theorie. Kontext 32 (4): 243–261. Schindler, R. (1957): Grundprinzipien der Psychodynamik in der Gruppe. Psyche 11 (5): 308–314. Schlippe, A. von; Kriz, J. (1996): Das “Auftragskarussell”. Eine Möglichkeit der Selbstsupervision in systemischer Therapie und Beratung. System Familie 9 (3): 106–110. Schlippe, A. von; Schweitzer, J. (2007): Lehrbuch der systemischen Theorie und Beratung. Göttingen. Schmidt, G. (2010): Liebesaffären zwischen Problem und Lösung. Heidelberg. Schmitt, A. (2004): Magische Gestalten auf dem Familienbrett. Familiendynamik 29 (1): 22–53. Schneider, K. (1999): Familientherapie in der Sicht psychotherapeutischer Schulen. Paderborn. Schulz von Thun, F. (1998): Miteinander reden. Reinbek. Schulz von Thun, F. (2010a): Miteinander reden 1. Störungen und Klärungen. Allgemeine Psychologie der Kommunikation. Reinbek. Schulz von Thun, F. (2010b): Miteinander reden 2. Stile, Werte und Persönlichkeitsentwicklung. Differenzielle Psychologie der Kommunikation. Reinbek. Schulz von Thun, F. (2010c): Miteinander reden 3. Das “innere Team” und situationsgerechte Kommunikation. Reinbek. Schweitzer, J. (1995): Kundenorientierung als systemische Dienstleistungsphilosophie. Familiendynamik 20 (3): 292–313. Schweitzer, J.; Weber, G. (1982): Beziehung als Metapher: Die Familienskulptur als diagnostische, therapeutische und Ausbildungstechnik. Familiendynamik 7 (Sonderdruck): 113–129.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
327
References
Seiwert, L. J. (2000): Selbstmanagement. Persönlicher Erfolg, Zielbewußtsein, Zukunftsgestaltung. 9. Aufl. Offenbach. Seligman, M. E. P. (2012): Der Glücksfaktor. Warum Optimisten länger leben. Bergisch-Gladbach. Selvini Palazzoli, M. (2006): Das Mailänder Modell – Ein Interview mit Mara Selvini Palazzoli. Geführt von Klaus Deissler am 10.4.1979 (http://www.systemagazin. de/buecher/klassiker/selvini_paradoxon.php). Selvini-Palazzoli, M.; Boscolo, L.; Cecchin, G.; Prata, G. (1981): Hypothetisieren – Zirkularität – Neutralität. Familiendynamik 6 (4) 123–139. Selvini-Palazzoli, M.; Boscolo, L.; Cecchin, G.; Prata, G. (2013): Paradox and Counterparadox: A New Model in the Therapy of the Family Schizophrenic Transaction. Lanham. Simon, F. B.; Stierlin, H. (2004): Die Sprache der Familientherapie: Ein Vokabular: Kritischer Überblick und Integration systemtherapeutischer Begriffe, Konzepte und Methoden. Stuttgart. Simon, F. B.; Rech-Simon, C. (2012): Zirkuläres Fragen. Systemische Therapie in Fallbeispielen – ein Lernbuch. Heidelberg. Sirringhaus-Bünder, A. (2011): Marte Meo – Videounterstützte Beratung und systemische Perspektive. In: Hawellek, C.; Schlippe, A. von (Hg.): Entwicklung unterstützen, Unterstützung entwickeln. Systemisches Coaching nach dem Marte Meo Modell. Göttingen, 227–241. Sommer, G. (1982): Gemeindepsychologie. In: Bastine, R.; Fiedler, P.; Grawe, K.; Schmidtchen, S.; Sommer, G. (Hg.): Grundbegriffe der Psychotherapie. Weinheim. Sommer, G.; Ernst, H. (Hg.) (1988): Gemeindepsychologie. München. Speck, R.; Attneave, C. (1987): Die Familie im Netz sozialer Beziehungen. Freiburg. Steiner, C. M. (2009): Wie man Lebenspläne verändert. Die Arbeit mit Scripts in der Transaktionsanalyse. Paderborn. Stierlin, H. (1982): Delegation und Familie. Frankfurt a.M. Stierlin, H. (1992): Von der Psychoanalyse zur Familientherapie. Stuttgart. Stierlin, H.; Rücker-Embden, G.; Wetzel, N.; Wirsching, M. (2002): Das erste Familiengespräch. Stuttgart. Stindl-Nemec, E. (2001): Wieder dabei. Systemische Sozialarbeit in der gemeindenahen Psychiatrie. Heidelberg. Trenkle, B. (2010): Das Ha-Handbuch der Psychotherapie. Heidelberg. Trenkle, B. (2013): Die Löwengeschichte. Hypnotisch-metaphorische Kommunikation und Selbsthypnosetraining. Heidelberg. Varga von Kibéd, M.; Sparrer, I. (2011): Ganz im Gegenteil. Grammatik und Praxis der Aufstellungsarbeit mit kleineren und größeren Systemen. Heidelberg. Walter, J. L.; Peller, J. E. (1992): Becoming Solution-Focused in Brief Therapy. Levittown. Watzlawick, P. (1977): How Real is Real? New York. Watzlawick, P. (Ed.) (1984): Invented Reality: How Do We Know What We Believe We Know? (Contributions to Constructivism). New York. Watzlawick, P., Bavelas, J. B.; Jackson, D. D. (2011): Pragmatics of Human Communication: A Study of International Patterns, Pathologies, and Paradoxes. New York.
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
328
References
Watzlawick, P., Weakland, J. H.; Fisch, R. (2011): Change: Principles of Problem Formulation and Problem Resolution. New York. Weber, G.; Simon, F.; Stierlin, H.; Schmidt, G. (1987): Familientherapie bei manischdepressivem Verhalten. Familiendynamik 12 (2): 136–161. Werner, E.; Smith, R. (2001): Journeys from Childhood to Midlife: Risk, Resilience and Recovery. Ithaca. White, M.; Epston, D. (1990): Narrative Means to Therapeutic Ends. New York. Williams, A. (1989): The Passionate Technique. Strategic Psychodrama with Individuals, Families and Groups. London. Williams, A. (1995): Visual and Active Supervision. London u. New York. Williams, A. (2003): Rituale: Impulse für Veränderung und Entwicklung. praxis im dialog. Zeitschrift des Praxis-Instituts für systemische Beratung, 13–16. Winnicott, D. W. (1965): Maturational Processes & the Facilitating Environment: Studies in the Theory of Emotional Development. Madison. Wirsching, M.; Scheib, P. (2003): Paar- und Familientherapie. Berlin. Wustmann, C. (2004): Von den Stärken der Kinder ausgehen. Das Konzept der Resilienz und seine Bedeutung für das pädagogische Handeln. Unsere Jugend 56 (10): 402–412. Zeig, J. (Ed.) (1980): A Teaching Seminar with Milton H. Erickson. Philadelphia. Zwicker-Pelzer, R. (2010): Beratung in der Sozialen Arbeit. Stuttgart.
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Index
A ABC analysis 46f. adaptation demands 126 alpha 91f., 155f. position 92f. anamnesis family 27 problem 27 anthropology 307 approaches 250 “aside” interview 262f. asset growth 290 attributes 44 authenticity 309 autonomy 308, 311 autopoiesis 159f., 308, 311, 313 B basic attitude 307 behavior descriptions 45 modeling 250 observe 43 behavioral 50 patterns 44, 46, 127 therapy 46 belief system 46 beta 91f. body position 260 body’s wisdom 175 boundaries 127 burnout process 311 C capital gain 291 carousel 118 change 161
accompanying 289 climate 292 perspectives 230 supporting 289 cheerleading 245, 290 choreography 166 circular 16, 40, 51, 64, 85, 128, 174 causality 24 claimant 101 clarification 165 coercion 313 cognitions 23 comments 225 ambivalent 235, 237, 282f. complaining 111 compliments 227 compulsory nature 114 concepts systemic-constructivistic 159 concerns 100 construct 309 constructions 22, 70 creating 247 deconstructing 247 studying 247 willful 22 constructivism 23, 160, 250 constructivistic approach 130 consultant 315, 317 contact initial 39 context-oriented 128 contexts 211, 308 contextualization 25, 63, 85, 160 contextualized framing 208 contract 32–35, 37–39, 41, 99, 100–102, 105, 120
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control 127, 313 convening strategies 252 coping 165 critical events 85 culture 134 curiosity 310 customer 101 cybernetics first-order 75 second-order 75
reconstructions 310 feedback 173 feeling 56, 174 final phases 296f., 299, 301 fluctuation 165 fluidifying 128 foreigners 134f. formation 166 foster home 143 future plans 223
D dance 172, 212 deconstruction 70, 248 description twofold 308 destabilization 165 diagnoses 123, 125 differences 30 directives 250 documenting 57 draftees 101, 114
G gamma position 91f. generic principles 164, 253 genogram 27, 58–64, 78, 85 goal 102, 137, 140–142, 144 goal-oriented 138 gossiping about present company 201 group 48, 88, 149–152 dynamics 90, 152, 154
E enactment 42, 261f. equilibrium 69 escalation complementary 51 symmetric 51 ethical counseling 307 ethical questions 310 ethics guidelines 307 evaluation 96, 148 evaluator 315, 317 externalization 268f., 271 F facilitator 315f. facts 26, 28 family as animals 182, 192, 254f. board 190 helper map 74, 78, 80 lineup 166
H helpers informal 79 professional 79 homeostasis 25 humor 289 hypnotherapy 240 hypotheses 122f., 125–127, 130f., 133, 149 culture-specific 135 migration-specific 135 psychological 135 I impartial 308 inducing the new 161 information 30, 57 information management 102, 105 initial encounter 21, 253 inner authorities 240, 243 inner team 240 interaction 47f., 50, 127
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Index
escalating 51 initial 32f., 35, 37, 39, 41 redundant 50 sequences 44 intercultural 134 counseling 245 interruption of symmetry 165 interventions 146 behavior-oriented 250 directive 159 paradoxical 236 interview initial 32 J joining 32, 274 L leave-taking 296–299, 301 life cycle 127 limitations 153, 258f. setting 261 linear 16, 40, 64, 85, 128, 174 looking back 300 M magical family 192 mandate 29, 35–37, 106, 119 ambivalent 107, 282 contradictory 111 control 116 establishing 116 hidden 107–109 impossible 119 open 107 resolving 118 secret 107 several different 111 map 65, 67, 69, 71, 73 memory lane 184 metaphors 122, 126, 272–275, 277f., 287 three-dimensional 166 verbal 180f.
miracle question 37, 112, 212, 217, 219, 222 mirroring 274 morphing slow-motion 172 N narrative 70, 132, 250 nearness-distance regulation 259 network 265 map 266, 268 neutral 69, 81 socially 82, 308 toward the outcome 82f. toward the process 82 normalizing 226 normative 69–71 not-knowing 130–134 O objective truth 309 objectivity 28, 123, 128 offer 119 omega position 92 P paradox trap 236 paradoxical 235 intention 235 intervention 236 mandates 236 partiality multidirected 81 parting processes 296 patterns disrupting 176 identifying 253 of leave-taking 296 perspectives change of 275 cultural 245 different 172 expanding 241 multigenerational 127
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332
Index
perturbation 138 phase initial 39 of family life 85 points of view 29 positions 307 positive psychology 289 power asymmetry 313 prepare 224 prescriptions 235 problem 162, 211 actualization 165 history 85, 213 orientation 160 solving 214 Q question circular 36, 198, 200, 208 classification and scaling 205 comparative 205 exacerbation 221 of agreement and disagreement 206 what-if 210 R ranking group positions 91 ranking orders 91 reactions emotional 54 physical 54 reality 24 referral 34, 35 reframing 208, 229–31, 235 relapse 293 conscious 223 faked 223 relationship 165 patterns 177, 178 structures 65, 67 triadic 68 reports 93f., 96 resilience research 228
resource 37, 45, 211, 216f., 227, 276, 308f. activation 165 orientation 160 respect 310 responsibility 309 restabilizing 165 rituals 285f., 301 role 44, 52, 307 change 264 models 243 of the counselor 315, 317, 319 S salutogenesis 163 research 228 scalings 178 scenic comprehension 45 sculpture 166f., 174 case reviews 193 chair 187 family reconstructions 194 favorite 179 inside-out 167 metaphor for time 184 outside-in 168 setting up 170 simultaneous 169 spontaneous 258 symbol 192 system’s ideal 172 seating arrangement 259 self-awareness 310 self-experience 310, 314 self-organization 308 self-reflexion 310 setting 102, 104 social atom 187 dynamics 48, 88 network 301 sociogram 88 sociometry 90
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Index
solution orientation 70, 132, 160, 162, 276 stability 164 staging 261 stance 29 stories 272, 274, 276 constructing 277 effects 278 structural constellations 197 family therapy 66 interconnection 132 structuralism 66 subgroup 154 subsystem 127, 168, 177 symbolization 268 symptom as metaphor 233 dance around 212 utilization 254, 304 synergetics 164 system 22, 24, 75 change 30f. earlier helper 74 evolution 25 existing helper 74 family-helper 76 helper 27, 74 informal support 74 limits 300 observance 25 observer 76
observer-observer 76 open 24 politics 106 social dynamics 47 T task 102f., 279f., 286 ambivalence 282 change 283 observational 281 teacher 315 team supervision 219 temporal processes 126 timeline 86 transition objects 301 traumatized persons 163 triangulation 72, 115 typical course 302 U unconventional 128 V values 154f., 307 vehicles developing 148, 304 using 254 VIP map 266 W witnessing 240, 242
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
© 2014, Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen ISBN Print: 9783525404539 — ISBN E-Book: 9783647404530
A reference and practical workbook
Johannes Herwig-Lempp Resource-oriented Teamwork A Systemic Approach to Collegial Consultation 2013. 216 pp, 10 fig., paperback ISBN 978-3-525-49160-7 eBook: ISBN 978-3-647-49160-8
Teamwork is expected to be a highly successful way to create synergies in organizations and companies. Yet all of us have had the experience of sitting through inefficient team meetings, spending too much time on organizational issues. Clearly collaborative consultation in its various forms is a common part of our daily work life. But does one organize working effectively in a team and as a team? On the basis of his long-standing experience as counselor and supervisor Johannes Herwig-Lempp developed a systemic approach to team support. In this book he shows how to easily learn, adapt and practice this techniques.
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Eine systemische Perspektive ist in allen Lebenslagen hilfreich
Rainer Schwing / Andreas Fryszer Systemische Beratung und Familientherapie – kurz, bündig, alltagstauglich 2. Auflage 2013. 168 Seiten, mit Illustrationen von Luise Rombach, kartoniert ISBN 978-3-525-45376-6 eBook (PDF) ISBN 978-3-647-45376-7 eBook (epub) ISBN 978-3-647-99550-2
Ein Buch für interessierte Menschen auch ohne fachliche Vorbildung, die wissen möchten, wie systemische Beratung funktioniert und wo sie angewandt wird. Mit vielen Fallbeispielen und wertvollen Tipps für den Alltag! Systemische Beratung und Therapiewirkt und ist weltweit verbreitet. Rainer Schwing und Andreas Fryszer plaudern aus dem Nähkästchen ihrer jahrzehntelangen Erfahrung mit systemischen Ansätzen und erklären deren grundlegende Prinzipien. Störungen und Krankheiten werden als Lösungsversuche gesehen, die irgendwie danebengeraten sind. Die zahlreichen konkreten Tipps aus dem systemischen Handwerkskoffer haben sich im Alltag bewährt und können direkt umgesetzt werden, um Probleme zu lösen oder überraschende neue Antworten auf lebenspraktische Fragen zu erhalten. »lnsgesamt ein Buch, das einen sehr gut verständlichen und leicht lesbaren Einblick in systemisches Denken und Handeln gibt und dabei den Fokus auf viele praktische Anregungen legt.« systhema (Andreas Klink)
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