It’s done, first lap of reading the initial papers from ANZ happened, some roller-coaster-experiences still reverberating. How to reflect such a skillful, extensive, thoughtful, inspired, and even punning multiverse of ideas (on the one side) and such a focus (on the other)? My first reaction reminds me of Kratylos, a Greek philosopher in tradition of Heraklit. He was said to simply moving a finger to and fro, when asked to answer questions. What could be the grounds from which I could feel sure enough to say something about the concerns with which Glenn, Carmel, Bruce, and Brian are dealing. Aren’t that my concerns, too? Of course they are, but I’m not sure whether I’m concerning from the same points of view (same points of view, somewhat irritating, isn‘t it? Anyway, may I ask you to tell something about the roller-coaster-experience, mister...?)
Well, first impression that struck me was the extent to which differentiations between "narrative" and "systemic" were dealt as a problem. There must be some specific background in the scene I’m not familiar with. Maybe due to some cultural or geographical reasons, or by accident eventually
How much I agreed when reading Glenn’s statement: "There is a desparate need for radical voices of difference in today’s economic and political climate of managed and evidence-based care in psychotherapy." But hesitated with the next sentence: "However a systemic family therapy (....) is not inconsistent with this sentiment." Why "however"? Hitherto it seemed to me a central part of my self-image as a systemic therapist! This shock was cushioned by the impression to have understood what Glenn wrote about Derrida’s ideas on deconstruction. So, this was what I thought I had been doing all the time, but just didn’t know? I think it was some figure of Moli¾ re who at a time realized with incredulous astonishment that he had been talking prose all the time! I had called that "looking for space to move", or "intrepid respecting" as Juergen Hargens called it. In general there was no doubt for me that I could agree with Glenn’s positions if I focused on his concern with an emancipating and respectful kind of professional psychosocial help, but would feel irritated when focusing on a systemic-narrative-gap.
Arriving to Carmel‘s contribution I soon found some of my reflections already "prereflected", talking about "narrative therapies", reflecting a much broader field than White County, and an eventual peculiar scene in ANZ. Could I add anything to her statement: "I’m not really a narrative therapist, but I’m interested in the ideas and use some of them"? Then she mentions something that sharpens my attention, the question of authenticity. Asking "As a client myself, would I have preferred an externalizing rather than an integrating frame?" Well that’s the sort of question I’m increasingly interested in. Let me say it this way: I wouldn’t believe any therapist who doesn’t give me an impression of how SHe deals with the inevitable gaps between his or her daily experience and his or her theory. "Practice itself can be very messy", oh yes it is, Carmel! Daring to deal with that honestly may allow bravery to dispense with "a desire for foundational commitment" and focus on "a particular framework". And does that mean, we are getting into contact with Mr. or Mrs. Smith instead of clients, patients or customers? And would Mrs. Smith’s possibility to "re-author" her story be the difference that makes a difference in contrast to clients‘ possibility to do that. I read Carmels ideas about the "relationship of narrative to progressive politics" with great interest.
Mr. and Mrs. Smith remind me of the autonomy topic and thus of another roller-coaster-experience. Maybe I should put in some of my ideas about what is crucial for respectful professional help. Clients‘ autonomy is a basic premise of such an approach as I see it. Autonomy not as a goal but as a starting point. This is expressed by therapist’s readiness for "intrepid respecting" and "respecting relationships" as Juergen Hargens pointed out (1995, 1997). However, reading Brian’s vivid review of White’s book on "Therapists‘ Lives" I find "autonomous" as contrary to "accountable", Jeez! "I Kant believe it", Brian, should I prefer to amputate my left or my right leg? Must have to do something with a big White hole on my map! Maybe words are not not all we have, I’d like to answer to Brian’s statement in his paper. I confess that Brian’s text found me very pleased with his stunning punning pieces, and maybe it is my affinity to that which makes me watchful reading "Words are all we have!", especially when reading "Moving on with the right words" short time later. In his matchless style Brian mocks at White’s statement about the "expert culture of psychotherapy". Of course, I smiled about the DICTAT-statement. On the other hand I felt a little bit pushed back. White’s words could have been exactly those I might have used to describe the situation here in Germany after the introduction of the new Psychotherapists‘ Law, which bases on and cements an extremly uncooperative and hierarchical version of professionalism. Its a horror for clients and for colleagues, and as Mr. Smith I’d pray not to get into a situation to be dependant to that. It’s Brian‘s text as a whole, i.e. as a context that leads me to the clear impression that Brian’s position and mine find themselves in a rather good neighbourhood. I wouldn’t take it as helpful to decide whether the idea of the importance of context(s) is part of a systemic or a narrative heritage. Does it make sense to call it "narrative" or "systemic" to bring into mind that words without a context of talking, listening, trying to understand, asking, answering, be silent and wait, is like a move that doesn’t move, some sort of "post-it-modernism".
So I come to Bruce’s "Embracing Uncertainty". This seems to me a very valid metaphor, not only because of its thoughtful discussion of socio-economic developments and its implications for professional help. There is a direct link to Hubble et al.‘s statement of "a great battle of the brands" (1999). And from that to the search for heroes, the "hero myths of the discipline" as Bruce stated. Needless to say that looking for heroes within the the professional pool is likely to end in resignation, a free-for-all fight, or some splendid isolation, isn’t it. Miller et al. (1997, Hubble et al. 1999) have been underlining an increasing number of data highlighting the clients as "unsung heroes" of psychotherapy. So we have to deal with another edge of the uncertainty-narrative. If the clients are the heroes of change, the contributions of professional helpers to that change come into a different focus. Seems to appear as some illegitimate sort of "evidence-based practice" that differences between therapeutic schools don’t have as much an impact on outcomes as some core qualities resembling all over the different descriptions of therapies.
That opens up space to reflect my position in the process of helpful change. And I have no idea how we could avoid differences, or diversity. Instead I’d prefer to look at the chance to become a multi-lingualist, as Glenn said. I agree with and like the Dulwich Centre statement: "Narrative therapy has particular links with Family Therapy and those therapies which have a common ethos of respect for the client, and an acknowledgement of the importance of context, interaction, and the social construction of meaning". That’s what I mean: Let us get to know, take into account, and use all those different ideas. Not as a must but as a pool of possibilities. The heart piece of it should be the common ethos of respect.
Let me add a personal and a hemispheric remark. The personal one: I think we have to take into account personal experience, not however defining the world, as Carmel said, but as a very valuable part. As I learned to know myself hitherto I think it would diminish my personal possibilities to be part of the helping process, if I had to sit "in our uncertainty and slowly create together a new discourse of understanding", as Bruce mentioned. It was inspiring for me to read Kogan & Gale’s (1997) paper on "Decentering Therapy", analyzing a Narrative Therapy session with White as therapist. I agreed with their conclusion: "postmodern therapy is not and cannot be "non-interventive" or without an agenda." However, as they stated: "it is important not to view these practices as techniques for "doing" postmodern therapy. Techniques imply a centered therapist who is doing something to the clients. A postmodern intervention attempts to acknowledge and act from a participant status. The therapist is active, but activity is generated from an insider position to the interaction" (p. 123).
How could we talk about autonomy and could figure out therapist's specific tasks as well given that collaboration is the central aspect of what happens in therapy? The importance of this question varies with the kind of payment, I suppose. If you are an employee, it would be better, if you could make clear what you think you are paid for. You could call it luck if officials would accept collaboration as a sufficient answer. So I looked for a description that would fit to both sides. I came to use the word co-piloting (in German: "Beisteuern"). Co-piloting refers to a more active picture of collaboration: the joint-venture of two (or more) experts coming to an understanding about direction, goals, and means of some change. Co-piloting isn't the same as "piloting". However, it isn't the same, too, as simply sitting asides. Co-piloting means the competence to participate in widening perspectives and opening up new possibilities. Furthermore it means being able to do that in a perceptible, responsible, and joining manner, building upon the premise that it is not possible to do that unilateral or by one's exclusive decision.
My part of Co-Piloting focuses on developing clinical contracts. I offer questions and suggestions helping to distinguish between causes for asking for help and clients‘ favours, followed by different offers to concretize goals, exceptions, and criteria for checking out already actual or future reaching of goals. Orienting to clients‘ commissions is the one base, honestly respecting helpers‘ own boundaries the other. This is not meant as a cookbook-style how-to-advice. It resembles what John Walter called "Personal consultation" (Loth & Walter 1998).
For me to do that I translated ideas about fundamental systemic attitudes into questions focusing fundamental qualities:
German sociologist Niklas Luhmann coined the term "unity of difference". This term seems to allow good orientation in dialogues of diversity and leads me to some hemispheric realms. I’m living in the European Community. Eleven languages are being spoken, each session of parliament, each contract has to be translated into each of the languages. This leads to interesting, sometimes dramatic experiences. We only have words, but words are not the same in different contexts, different languages. Members of European Parliament share their impression that there is more interaction between MPs of the same language than between those of the same party with different languages. Because only few are really experts in increasingly overlapping English language, MPs tend to focus on the technical aspects of topics. So maybe I’d have to confess that eventually I’m rather some kind of German speaking therapist than a systemic, narrative or other one? (And as an author my primary reflecting team consists of me and my dictionary?). I have to think it over.
Literature:
Hargens, J. 1995. Kurztherapie und Lösungen – Kundigkeit und respektieren [Brief Therapy and Solutions – Expertness and Respecting], in: Familiendynamik 20(1), pp.32-43.
Hargens, J. 1997. Respecting Relationships. In: J. of Systemic Therapies 16(2), pp.173-180.
Hart, B. 1995. Re-authoring the stories we work by: Situating the narrative approach in the presence of the family of therapists. In: ANZJFT 16(4), pp.181-189.
Hubble, M.A.; B.L. Duncan & S.D. Miller [Eds.] 1999. The Heart & Soul of Change. What Works in Therapy. Washington,D.C.: American Psychological Association.
Kogan, S.E. & J.E. Gale 1997. Decentering Therapy: Textual Analysis of a Narrative Therapy Session. In: Family Process 36(2), pp.101-126.
Loth, W. 1998. Auf den Spuren hilfreicher Veränderungen. Das Entwickeln Klinischer Kontrakte [Tracking Down Helpful Changes. Developing Clinical Contracts], Dortmund: verlag modernes lernen.
Loth, W. 1999. Systemische Hilfen als Kooperation nachweisen – "Kontraktorientierte Leistungsbeschreibung" [Referring to Systemic Help in Terms of Cooperation – Contract-Oriented Description of Performance], in: Familiendynamik 24(3), pp.298-319.
Loth, W. & J. Walter 1998. From Solution-Focus to Personal Consultation – An E-Mail-Interview. http://home.t-online.de/home/kopiloth/jwinteng.htm
Luhmann, N. 1984. Soziale Systeme [Social Systems], Frankfurt/M.: Suhrkamp.
Miller, S.D.; B.L. Duncan & M.A. Hubble 1997. Escape From Babel. Toward a Unifying Language for Psychotherapy Practice. New York/London: Norton.
Par¾ , D.A. 1995. Of Families and Other Cultures: The Shifting Paradigm of Family Therapy. In: Family Process 34(1), pp.1-19.
White, M. 1988. The Process of Questioning. A Therapy of Literary Merit? Dulwich Centre Newsletter [In German: 1989, Familiendynamik 14(2), pp.114-128]
White, M. & Epston, D. 1989. Literate Means to Therapeutic
Ends. Adelaide: Dulwich Centre Publications [In German: 1990: Die Zähmung
der Monster. Der narrative Ansatz in der Famlientherapie].
Wolfgang Loth (Bergisch Gladbach), kopiloth@t-online.de
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