- •Some Further Family Considerations
- •Enabling and Disabling Family Systems
- •Family Structure
- •Gender Roles and Gender Ideology
- •Cultural Diversity and the Family
- •Family Interactive Patterns
- •Family Narratives and Assumptions
- •Family Resiliency
- •The Perspective of Family Therapy
- •Summary
- •Recommended Readings
- •Social Factors and the Life Cycle
- •Developing a Life Cycle Perspective
- •The Family Life Cycle Framework
- •A Family Life Cycle Stage Model
- •Changing Families, Changing Relationships
- •Summary
- •Recommended Readings
- •Gender Issues in Families and Family Therapy
- •Multicultural and Culture-Specific Considerations
- •Summary
- •Recommended Readings
- •Some Characteristics of a Family System
- •Beyond the Family System: Ecosystemic Analysis
- •Families and Larger Systems
- •Summary
- •Recommended Readings
- •Historical Roots of Family Therapy
- •Studies of Schizophrenia and the Family
- •Marriage and Pre-Marriage Counseling
- •The Child Guidance Movement
- •Group Dynamics and Group Therapy
- •The Evolution of Family Therapy
- •Summary
- •Recommended Readings
- •Professional Issues
- •Maintaining Ethical Standards
- •Summary
- •Recommended Readings
- •7 PSYCHODYNAMIC MODELS
- •The Place of Theory
- •Some Historical Considerations
- •The Psychodynamic Outlook
- •Object Relations Theory
- •Object Relations Therapy
- •Kohut and Self Psychology
- •Summary
- •Recommended Readings
- •8 TRANSGENERATIONAL MODELS
- •Eight Interlocking Theoretical Concepts
- •Family Systems Therapy
- •Contextual Therapy
- •Summary
- •Recommended Readings
- •9 EXPERIENTIAL MODELS
- •A Shared Philosophical Commitment
- •The Experiential Model
- •Symbolic-Experiential Family Therapy (Whitaker)
- •Gestalt Family Therapy (Kempler)
- •The Human Validation Process Model (Satir)
- •Summary
- •Recommended Readings
- •10 THE STRUCTURAL MODEL
- •The Structural Outlook
- •Structural Family Theory
- •Structural Family Therapy
- •Summary
- •Recommended Readings
- •11 STRATEGIC MODELS
- •The Communications Outlook
- •The Strategic Outlook
- •MRI Interactional Family Therapy
- •MRI Brief Family Therapy
- •Strategic Family Therapy (Haley and Madanes)
- •Summary
- •Recommended Readings
- •12 THE MILAN SYSTEMIC MODEL
- •Milan Systemic Family Therapy
- •Questioning Family Belief Systems
- •Summary
- •Recommended Readings
- •Behavioral Therapy and Family Systems
- •A Growing Eclecticism: The Cognitive Connection
- •The Key Role of Assessment
- •Behaviorally Influenced Forms of Family Therapy
- •Functional Family Therapy
- •Conjoint Sex Therapy
- •A Constructivist Link
- •Summary
- •Recommended Readings
- •The Impact of the Postmodern Revolution
- •A Postmodern Therapeutic Outlook
- •The Post-Milan Link to the Postmodern View
- •Reality Is Invented, Not Discovered
- •Social Constructionist Therapies
- •Summary
- •Recommended Readings
- •Poststructuralism and Deconstructionism
- •Self-Narratives and Cultural Narratives
- •A Therapeutic Philosophy
- •Therapeutic Conversations
- •Therapeutic Ceremonies, Letters, and Leagues
- •Summary
- •Recommended Readings
- •Families and Mental Disorders
- •Medical Family Therapy
- •Short-Term Educational Programs
- •Recommended Readings
- •Qualitative and Quantitative Research Methodologies
- •Couple and Family Assessment Research
- •Family Therapy Process and Outcome Research
- •Evidence-Based Family Therapy: Some Closing Comments
- •Summary
- •Recommended Readings
- •Family Theories: A Comparative Overview
- •Family Therapies: A Comparative Overview
- •Summary
- •Recommended Readings
SOCIAL CONSTRUCTION MODELS I 343
experiences and viewpoints of individual family members need to be attended to, and the family’s interaction with larger systems (schools, social agencies) addressed. All views of events and relationships are valued equally, irrespective of the person’s gender, social class, cultural background, or sexual orientation.
A therapist’s prejudgments, then, despite his or her expertise, cannot be considered objective or unbiased. Any subsequent interventions to change the way a family operates may run the risk of imposing a conventional or socially sanctioned view of what constitutes a normal or stable or happy family, or how a family judged to be dysfunctional must change its behavior. The postmodern view rejects the dogmatic notion that the therapist sees the world as it really is, while clients distort their picture of reality. Instead, therapists influenced by social constructionist thinking are apt to take a “not knowing” stance (Anderson & Goolishian, 1988), replacing the predetermined view of how a family should change with a collaborative posture in which all participants— family members and therapist equally as co-investigators—examine the belief systems by which the different family members view “reality.” After each family member has considered his or her own assumptions about the world that form the basis for the meanings he or she gives to events, the family and therapist are in a position, together, to generate or co-construct new views of the family’s “reality”and new options its members might pursue. Instead of concentrating on the origins of problems, the therapist turns, together with family members, to finding workable solutions—searching for possibilities rather than pathology. In the process, the family may be helped to clarify and revise some of the central themes of its personal narratives or stories about its members.
THE IMPACT OF THE POSTMODERN REVOLUTION
For a modernist, the world is simply out there, available for observation (Gergen, 2001). Postmodernists, on the other hand, argue that what we call reality is not an exact replica of what is out there, but rather is socially or communally constructed. As Freedman and Combs (1996) observe:
A central tenet of the postmodern worldview in which we base our approach to therapy is that beliefs, laws, social customs, habits of dress and diet—all the things that make up the psychological fabric of “reality”—arise through social interaction over time. In other words, people, together, construct their realities as they live them. (p. 23)
Postmodern thinkers emphasize that our beliefs about the world—what constitutes reality—are social inventions, not a reflection or map of the world; they evolve from conversations with other people. It is through the interactive process of language (not merely words, but gestures, facial expressions, vocal inflections, silences) that people connect and construct their shared views of reality. The development of knowledge, then, is a social and cultural phenomenon, mediated through language, and not an objective representation of reality. The concept of adolescence, for example, was not considered a specific period of human development until recently. Did that period suddenly appear, or did people begin within the last century to sort out their perceptions into types or classes based on chronological ages? Obviously the latter explanation makes more sense.
Gergen (1985, 1999) calls attention to such modern concepts as “romantic love” or “maternal love” as invented social constructions. In our times, “codependent” or
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“adult child of alcoholics” or “gay” or “bipolar” or “borderline” are invented terms— social constructions—that we personify, as though they existed. In the postmodern view, each is simply a contrived or invented label that clients and therapists alike may bring to therapy. This can be a useful and handy way of communicating. But it also can have a dangerous consequence, de Shazer (1991) maintains, because as therapists we run the risk of reifying concepts borrowed from first-order cybernetics (such as homeostasis) and describing families as though families really possess those concepts—and those concepts explain their problems.
Postmodern thinkers employ the construct of constructivism to emphasize the subjective construction of reality. Our knowledge of the world derives from our own creating, ordering, constructing, and giving meaning to what we experience, not a world as it objectively exists. That is, each of us constructs a sense of the world out there based on our own previously held dominant beliefs, which in turn reflect the dominant beliefs of society. Those beliefs are kept alive and passed along through stories or narratives we share in conversations with one another. Moreover, these narratives play a key role in organizing and maintaining a view of ourselves and our life situations. People organize their experiences and even their memories primarily in the form of self-narratives—personal and family stories, myths about family characteristics or circumstances, reasons for doing or not doing something—to gain some sense of order, continuity, and meaning in their lives. Each of us unavoidably views the world, as Parry and Doan (1994, p. 24) put it,“through the lens of a succession of stories—not only a personal story, but gender, community, class, and cultural stories.”
A POSTMODERN THERAPEUTIC OUTLOOK
Rather than adopt a systems view—which, according to Lynn Hoffman (1990), runs the risk of seeing family members as objects the therapist can program from the outside— postmodern-oriented therapists attempt to collaborate with family members as selfcreating, independent participants. There is an assumption of a shared expertise among all participants. The therapist is no longer a detached, powerful outside observer or sole expert but rather a partaker, with his or her own set of prior beliefs, ready to play a role with family members in constructing the reality being observed. No longer needed to give directives as sole expert, the therapist works with the clients to retell and relive stories and to co-construct possible alternative stories or new outcomes. The therapist engages in a dialogue with family members, helping them shake loose from a set or fixed account of their lives (a story from which they often see no escape) so that they might consider alternatives offering greater promise.
Moving away from exerting power and control over the sessions or establishing authority over clients, these therapists are interested in the shared set of premises of reality a family attaches to a problem that perpetuates its behavior. Together, as part of a unitary therapist-family observer system, therapy becomes a cooperative undertaking in which new meaning and understanding are jointly constructed rather than imposed by the therapist. With new outlooks, family members develop more empowering stories about themselves and as a result find new ways of coping with their difficulties.
Instead of presenting the familiar detached and presumed “objective” assessments by an expert, social constructionists take the position that what is called for is a collaborative dialogue between therapist and family, who respectfully and nonjudgmentally hold “conversations” in which together they examine the meanings each
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participant has given to the family’s problems. For example, Harlene Anderson’s (1997) not-knowing stance (which we describe in more detail shortly) allows the therapist to follow leads as openings develop rather than imposing some predetermined scheme or framework for uncovering patterns. Several implications follow from this outlook (Goldenberg & Goldenberg, 1999):
The therapist has permission not to be an expert. He or she does not bring to sessions preconceived ideas of what the family should or should not change. Put another way, the therapist learns to do something with the family rather than to the family.
There is greater acceptance of eclecticism. Moving beyond employing specific intervention techniques, the therapist can more readily combine techniques (cognitive, systemic, constructivist) or modalities (individual, couple, family).
There is increased likelihood to attend to diversity issues. By avoiding being boxed in by conventional views of normal family life, and not looking for the“truth”of the situation, the therapist can learn about differing views offered by different family members, rather than falling into the trap of promoting his or her own socially acquired prejudices.
Clients and therapists alike are empowered by believing their situation is changeable. If accounts of misery or personal failure that troubled families bring to therapy are redefined not as “truths” but rather as social constructions, the prospect of developing alternate accounts of their lives becomes more attainable.
THE POST-MILAN LINK TO THE POSTMODERN VIEW
One of the unique developments of the post-Milan approach, as espoused by Boscolo and Cecchin, was its move toward a second-order cybernetic viewpoint. In practice, that includes a joint, nonhierarchical relationship with families in order to encourage self-examination and provide an opportunity for change without adhering to any prior agenda set by the therapists as to specific therapeutic goals. More inquisitive (Cecchin, 1987) than strategically manipulative, Boscolo and Cecchin took the position that therapists should invite family members to examine their meaning system, and to explore their options, instead of intervening with therapist-formulated directives. Together, therapists and family members can co-construct new ways of considering their choices, creating the possibility of discovering previously unexplored ways of looking at their situation and its remediation. Circular questioning (“Which one of your parents would you turn to in an emergency?”“Who in the family shows the most upset when your parents quarrel?”) is especially facilitative here, orienting all the participants to seeing themselves within a relationship context while learning of each other’s perspective on what is taking place within the family.
This collaborative post-Milan position provided an influential link to postmodernism.Through the use of a neutral stance and the technique of circular questioning, the post-Milan therapist allows the family to give meaning to how its members have organized or defined their lives. The initial systemicist efforts to take a neutral stance and employ circular questioning led its creators to understand that the questioning process itself is an intervention, defusing the family’s emotional intensity and allowing its members to hear other views of the problem. Thus, the therapist’s task came to center on this questioning process and its effectiveness based on the types of questions posed in the course of therapy.
Clinically, the therapist is interested in helping the family to reconsider the meaning of its predicament and, if its members choose to do so, encouraging them to make
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changes on their own. The therapist does not directly try to change the system or determine how it should change. This effort to help families explore their choices—and by implication the consequences of those choices—contrasts sharply with more traditional family therapy approaches, in which the therapist more directly tries to undo rigid family structures or what he or she perceives to be faulty family interactive behavior patterns. This post-Milan theoretical perspective, along with its second-order cybernetic therapeutic implications of the therapist being part of the system he or she is observing, is a precursor to the social constructionist approaches in family therapy.
REALITY IS INVENTED, NOT DISCOVERED
Postmodern thinking draws attention to the ways people make assumptions and draw inferences about—give meaning to—their problems. It contends that truth is relative and dependent on context, and that our belief systems merely reflect social constructions we make about our world—points of view, not “true” reality (Gergen, 1999). If each of us invents our own reality, we also have the option of creating it differently (Watzlawick, 1984).
To offer some historical context, modern psychology places great emphasis on the development of logical and empirical methods for discovering objective truths.Verifiable through replicated research, valid and generalizable laws regarding human behavior are assumed to emerge that correspond to observable reality. From this perspective, we live in a knowable world in which there are universal truths, expressed in cause-and- effect terms, that can be discovered by a detached observer. That observer, as far as possible, attempts to exclude his or her value biases from the research inquiry. Working from hypotheses stated in propositional form and subject to empirical verification, the researcher strives to control as many variables as possible, narrowing the experimental inquiry to the single independent variable under scrutiny, stripped of any context of which it may be a part.
From a clinical perspective the modernist outlook, elaborated in previous chapters, would define the therapist’s task as helping families (by providing insight, or promoting differentiation, or clarifying boundaries, or prescribing tasks) to deal more effectively with their situations. From this framework, the therapist is viewed as a skilled observer who looks for, diagnoses, and disrupts the family’s pathological cycles, enabling the family to move on (Slovik & Griffith, 1992). However, as Doherty (1991) points out, an increasing number of family therapists have become skeptical of modernist preconceptions, claiming that the prevailing theories of family systems are merely a by-product of mid-twentieth-century modernist culture and reflect its biases and underlying assumptions regarding what constitutes truth or reality.
In particular, Doherty argues that a family therapy based on modernism by and large fails to deal adequately with issues such as gender, ethnicity, and the impact of forces within the larger social system such as political and economic factors. Moreover, defining precisely what constitutes normal families becomes harder and harder to do when we live in an era of single-parent-led families, stepfamilies, gay and lesbian couples, dual-career households, and so on. By narrowly focusing on family interaction as the source of family disharmony, the modernist view, as exemplified by the cybernetic outlook in family therapy, fails to consider the underlying assumptions of the broader social context (for example, ingrained, society-reinforced, patriarchal patterns) on therapists’ prevailing attitudes.
