Theories and Methods of Family Therapy: Post-Modern Models

1. Theories and Methods ofFamily Therapy:Post-Modern Models • University of Guelph • Centre for Open Learning • and Educational Support William Corrigan, MTS, RMFT AAMFT Approved Supervisor (519) 265-3599 williamcorrigan@rogers.com

2. Definitional Ceremony Redux • Reflect on our discussions yesterday: • What were you drawn to? (expression) • What images/metaphors were evoked through our discussions? (image) • What personal experiences resonate with these expressions? (resonance) • How has your own life been touched by these expressions? (transport) 2

3. Today • Cooking Class • Tyranny & Freedom • Temptations of Power & Certainty • Lunch • Collaborative Therapy • Group time • Evaluate the Day

4. Cooking Class (does everyone know how to cook?)

5. Recipes: • Bowen stew • Cognitive-behavioural cassarole • Structural salad • Strategic soup • Psychoanalytic stroganoff • Experiential eggs benedict

6. Dinner Guests: • Joined-to-mom Jim • Sir Nigel • No-school Sandy • Sobriety-seeking Sally • Jack and Jill and Tina • Bounced-around Bob

7. Debriefing • How was each meal received? • What was it like as the host/hostess (therapist)? • What was it like as the guest (client)?

8. Tyranny & Freedom(Fine & Turner, 1991) • Brainstorm: • How does adherence to ideas in Family Therapy open space (create freedom) or close space (create tyranny) in the therapeutic relationship?

9. Tyranny & Freedom (Fine & Turner, 1991) • Shift from therapist as privileged, objective-management consultants to participant-facilitators • The client’s certainty is as legitimate and valid as our own • Heightened awareness of subjectivity; invites self-reflection; promotes flexibility Fine, M. & Turner, J. (1991). Tyranny and Freedom: Looking at Ideas in the Practice of Family Therapy. Family Process, 30(3), 307-320.

10. Tyranny & Freedom (Fine & Turner, 1991) • May inadvertently impose ideas on clients which results in increased constraint for client (e.g. the client who doesn’t come back) • “We cannot not theorize, nor can we stop from forming ideas” • Set ideas or theories may restrict our points of view • Need ability to view things from multiple perspectives

11. Tyranny & Freedom (Fine & Turner, 1991) • When therapists’ ideological positions make it difficult to open space for client’s ideas share this dilemma with client (transparency) • Curiosity about differences can open up space • Examples of how knowledge becomes privileged e.g. “normal” development; what is “healthy” • How dominant beliefs from one’s own culture influence clinical work e.g. “normal eating”

12. Tyranny & Freedom (Fine & Turner, 1991) • Four Practices for opening space: • inviting “outside” observers • supervision, peer supervision, reviewing audio/videotape of sessions • working with a reflecting team, co-therapist, outsider witnesses (MW) • multiple voices • reduces chance of getting stuck in one view of person or problem

13. Tyranny & Freedom (Fine & Turner, 1991) • historicizing • reviewing one’s professional past to see how your own ideas have changed over time (e.g. professional genogram from Day One) • journaling, creating a timeline, writing a philosophy of therapy or change, dialoguing with other professionals, self-reflection on how your current ideas open or close space for clients

14. Tyranny & Freedom • inviting clients to observe • regularly ask clients for their views about your ideas, what fits/doesn’t fit, what has been helpful/not helpful • have clients review session notes for accuracy • video/audiotape sessions and provide clients with a copy for review (JF)

15. Tyranny & Freedom (Fine & Turner, 1991) • Become theoretically agnostic • don’t favour one single domain or class of theories (i.e. theoretical relativism) • Be flexible • able to move in and out of theories when they no longer seem to fit • Become an observer of ideas and theories as well as a participant in them • critical reflection

16. Tyranny & Freedom (Fine & Turner, 1991) • Adopt a both/and position (dialectics) • brings forth contradictions to provide the impetus for change (i.e. devil’s advocate) • dialectics promotes a more comprehensive picture of a particular situation • challenges black/white, right/wrong • Remember that “certainty is not a proof of truth” • stay tentative • be curious vs. certain

17. Break 10:30-10:45

18. Temptations ofPower & Certainty • To address the “disabling aspects of power and certainty…in the therapeutic encounter” • Therapist’s power in relation to the client • Pursuit of certainty runs the risk of producing rigidity or inflexibility in the practitioner and in the practice Amundson, J., Stewart, K. & Valentine, L. (1993). Temptations of Power and Certainty. Journal of Marital and Family Therapy, 19(2), 111-123.

19. Temptations ofPower & Certainty • Questioning not only the client by ourselves and the certainties of our disciplines • Our expertise and specified knowledge run the risk of subjugating rather than liberating

20. Temptations ofPower & Certainty • Pursuit of absolute certainty or truth is the temptation to believe we may have something in a total sense • These attempts may weaken us by closing off options, seizing us up, and reducing flexibility

21. Temptations ofPower & Certainty • Therapy is a joint venture, where therapist acts as co-conspirator with the client(s) in the creation of a therapeutic reality • Curiosity and the desire to empower become antidotes to power and certainty

22. Amundson, J., Stewart, K. & Valentine, L., 1993, p.118

23. Amundson, J., Stewart, K. & Valentine, L., 1993, p.119

24. LUNCH 12:30 – 1:15

25. Collaborative Therapy A Philosophy of Therapy

26. The important thing is not to stop questioning. Curiosity has its own reason for existing. - Einstein

27. Knowledge • knowledge is embedded within history, context, culture, language, experience, and understanding • quote on p. 9 about knowledge • focus is on learning about the first-person-lived experience and about the uniqueness of it instead of similarities and patterns (8-9)

28. Social Constructionism • social constructionism concerns itself with the way that people arrive at their descriptions, explanations, and understandings of themselves and the world • it is not concerned with the literalness of the thing or the idea itself, but with the meanings attributed to it (12)

29. Social Constructionism The Self is only a shadow cast in language – Wittgenstein • in therapy, we meet people whose problems can be thought of as emanating from social narratives and self-definitions or self-stories that do not yield choices or that blind a person to choices (17)

30. Dialogue • dialogue is talking or conversing with another (or with oneself) toward a search for meaning and understanding • a search for understanding is not to seek the undiscovered but to look at the familiar with scrutiny, with new eyes and ears, to see and hear it differently, to understand it differently, to articulate it differently • dialogue involves not-knowing and uncertainty (34)

31. Inner Dialogue “I never know what I mean until I say it” – Harry Goolishian • paying attention to and clarifying inner dialogue • share your private thoughts with, and talk with, the client not about them (transparency) • don’t say anything to anyone that you wouldn’t say in front of the client

32. Listening • Listen, hear, and speak respectfully • respect is relational and it is communicated both verbally and non-verbally • Listen, hear, and speak as a learner • be genuinely curious about the other

33. Listening • Listen, hear, and speak to understand • do not understand too quickly - be tentative with what you think you might know • Listen, hear, and speak with care • pauses are important - take time to listen and take time before you speak • Listen, hear, and speak naturally • listening, hearing, and speaking are relational activities and processes; they are not techniques

34. Exercise:“Do You Mean...?”

35. A meeting of two: eye to eye, face to face. And when you are near I will tear your eyes out And place them instead of mine, And you will tear my eyes out And will place them instead of yours, And I will look at you with your eyes And you will look at me with mine. - J. L. Moreno, Invitation to Encounter

36. Client as Expert • the client is considered the expert on his or her life and is the therapist’s teacher • the therapist respects, honours, privileges, and takes the client’s reality seriously • this does not mean that therapist knowledge is not valued; it means that the therapist is not the expert on the client’s life • the therapist’s competence or expertise is in establishing and fostering an environment that naturally invites collaborative relationships and generative conversational processes (46-67)

37. Not-Knowing • not-knowing refers to the therapist’s view regarding knowledge, and a positioning of knowledge • a collaborative therapist takes a skeptical and tentative approach to knowledge, including its substance, its use, its certainty, its risks, and its implications (48)

38. Four Aspects of Not-Knowing • The idea of pre-knowing vs. knowing with • therapists do not believe that they can know another person or their circumstances beforehand • such knowing can inhibit being interested in and learning about the uniqueness of that person • knowing inhibits curiosity

39. Four Aspects of Not-Knowing • The way the therapist thinks about knowledge • the knowledge that each participant brings to a relationship and conversation is equally valued • what each brings to a conversation will be influenced and changed in some way (co-creation through dialogue)

40. Four Aspects of Not-Knowing • The intent with which the therapist uses knowledge • therapists do not invest in privileging their knowledge over another’s or persuading them of it • knowledge is offered as food for thought, as a way of participating in a conversation (tentatively)

41. Four Aspects of Not-Knowing • The manner in which the therapist offers knowledge • therapists honour, make room for, and give authority to the client’s voice and do not overshadow, divert, or subjugate it with their own knowing • knowledge is introduced in a tentative and provisional manner

42. Some Final Thoughts • client expertise, therapist not-knowing, and uncertainty do not suggest that a therapist acts or talks without confidence, withholds a response to a client’s request for answers, or ignores a client’s need for certainty • if a therapist assumes this philosophical stance, they will naturally and spontaneously act and talk in ways that create a space for, invite, and foster conversations and relationships in which clients and therapists “connect, collaborate, and construct” with each other (53-54)

43. Collaborative Therapy • Hoffman • Metaphor • Reach for connection beyond the scope of words • Three pillars of wisdom: • Not-knowing – if you want to know something, ask the client; check your assumptions; open space (freedom) • The reflecting team – privilege clients knowledge • Witnessing – having an audience reinforces change

44. Collaborative Therapy • Andersen • We create meaning through (all different forms of) expression • Meanings in expression are very personal, subjective • Everything is changing • We ae both “being” and “becoming” • Meanings are created problems • When two people have the same meanings, little new is developed • When two people have different meanings, a talk between them may create new and useful meanings

45. Collaborative Therapy • Penn • Careful listening to client and self; check internal voices • “listening is the most profound source of healing” • “radical listening” – what is absent and unspoken • Compassion makes us available to the client, more open

46. Collaborative Therapy • Levin • Scientific objectivity is a socially constructed myth (because researchers can’t be objective) • Women who have been battered describe feeling unheard by professionals (re-victimized?) • Understanding is mutually collaborative and dialogical in nature • “women who have been battered” vs. “battered women” – use of language

47. Collaborative Therapy • Levin • Not-knowing: “the newness of the client demands the question as opposed to the question being driven by theory” (p. 114) • “Therapists fail to hear their clients when they try to understand them and their problems too concretely, too enthusiastically, too expertly, or too quickly” (p. 121)

48. Collaborative Therapy • Fernández, Cortés & Tarragona • Curiosity, opening space, client as expert • Eating disorders as “loss of voice” • Client’s story takes center stage • Collaborative inquiry • No predetermined way of working with clients • Flexibility – working with uncertainty • Ideas offered in an exploratory manner

49. Collaborative Therapy • Fernández, Cortés & Tarragona • “Collaboration was the most important aspect of our work” (p. 142) • Being curious about clients’ lives and their understandings of their problems • The paradox of control; surrender to win 20

50. Collaborative Therapy • Andrews • Definitional ceremony and re-membering elders into their community • Wanting to be listened to uninterrupted • Use of reflection teams, a social event • Meaning created through life stories being witnessed • Students developing desire to listen with intense intention • Listening for strengths instead of pathologizing deficits