Lecture 6 systemic therapy with individuals

Lecture 6: Systemic therapy with Individuals

Systemic Comparative Kevin Standish

Newham College University Centre

Learning Outcomes

• Social constructionist approaches to Self• Describe the changes to the core Milan

principles: Curiosity to self-other-reflexivity • Give a critical review in relation to their own

model of practice

Social constructionism

• Social constructionism: critiques the idea that it is possible to discover any objective truth about our social lives.

• Instead we constantly are in the process of co-constructing our realities within a specific cultural context, through complex communication processes using all aspects of language


• The post-Milan systemic practitioners embraced social constructionist thinking.

• Constructivism: communication as a cognitive process of knowing through perception.

• Constructionism: communication as a social process of creating the world.

• Language creates reality: • Things are what we say they are!

or

Things are what we say they are!


• The influence on therapy: clients are invited to answer from their own experience and tell the therapist about their world view.

• Rather than the therapist making statements or giving interpretations which tell the client what therapist knows.

• This created a profound shift to an interpersonal perspective and helped liberate individuals from the oppressive and pathologising frameworks of older models

SOCIAL CONSTRUCTIONIST APPROACHES TO SELF

Social constructionist approaches to Self• Nature versus Nurture debate- most would argue that

human beings are much more than a collection of physical and psychological characteristics. Our selves are a combination of nature and nurture.

• At birth, babies have no sense of self. They do act on their own- the eat, cry, sleep, and so on, but this is not a conscious of self which develops later in life. Babies cry when they are hungry not because they think "If I cry, I will get Mom's attention," but rather because they feel discomfort. As children age, they are able to exert greater control over their conduct. However, humans also must develop cognitive capacities through interactions with others that allow them to differentiate self from others, to understand and use symbolic language, and to take the roles of others.

Social constructionist approaches to Self• To distinguish yourself from others, you must first recognize

yourself as a distinct entity. The first step is to distinguish yourself (your face and body) from the rest of the physical environment. Humans are not born with this ability, but most studies suggest that it develops around 18-months of age.

• The second step in the acquisition of self is the development of speech. Language acquisition relies on neurological development as well as input from others, often from parents.

• Parents speak with children, and children learn to make the sounds, imitate sounds, and use sounds as symbols for particular physical sensations or objects. This learning process gives the child access to the pre-existing linguistic world in which his or her parents and others live. The child learns the names of concrete objects as well as abstract ideas that cannot be directly perceived.

Social constructionist approaches to Self

• Children learn that they are objects and have names. A child who learns that others are referring to her when they make the sound "Elena," and that she can too use "Elena" to refer to herself, has taken a significant leap forward in the acquisition of self.

• The child now can visualize herself as a part of the named world and the named relationships to which she belongs. By observing how people act toward themselves, they can learn the meaning of themselves.

• symbolic interactionists referred to this process as acquisition of the looking glass self.


• In this process we imagine how we might look to other people; interpret their responses to us; form a self-concept, based on pride or shame, from their response.

• Reflected appraisal- the idea that a person bases his or her self-concept on the reaction he or she perceives from others during social interaction


• Studies show that it is the perceived reactions of others, rather than their actual reactions, that are crucial for self-concept formation.

• This occurs because feedback we receive is often inconsistent or even contradictory; is ambiguous and often difficult to interpret

• we must rely on our perceptions of others' reactions to construct our self-concepts.

The importance to therapy

• Since therapists are afforded a powerful position in our culture, the therapist’s ways of talking and acting have a powerful impact on the reality that gets co-constructed with in the therapeutic conversation.

• The way we talk with clients affects how they come to describe themselves

Emotions are socially constructed

• Feelings and emotions, like other aspects of our social life, evoked local moral values which are learnt with in our family, community, society and culture.

• Emotion is a master cultural category, that is constructed primarily by people rather than by nature, through the use of language in specific situations/context.

• Systemic therapists are curious about the person’s ideas: exploring how they came to feel and emotion, and express it in that way


• Feelings and emotions are learnt within family community and culture

• Emotions of culturally constructed and culturally specific• Emotions are historically specific: e.g. melancholy has now

been replaced with depression• We need to be curious about where and in which context

a person has develop their unique ways of doing particular feelings

• The therapist’s job is to help the client in deconstruct their emotions making sense of the social and cultural rules involved


• The rules for the correct use of emotion falls into four groups:

• 1. The felt bodily disturbance;• 2. The characteristic display of the emotion in

context;• 3. The word be choose to describe the emotion;• 4. The social act of communicating the emotion.

The importance of context

• Context lies at the heart of social constructionist approaches and shows that reality is always context dependent

• “words do not have any inherent meaning, the only makes sense when we know the context in which they are used” Wittgenstein (1953).


• In every context there are potential numerous meanings, if we are willing to see them.

• New information can shift the context and the meaning of an action

• By seeing action in a different context, unnoticed aspects become visible and the whole meaning of the interaction is altered.

• When the client describes thoughts, feelings and actions in their lives, all these have taken place within the context of particular relationships


• Particular stories and actions affect a context, and the context in turn affects those stories and actions: recursive feedback loops.

• Coordinated management of the meaning (CMM) Cronen & Pearce (1991/2):the language we use and actions we take are influenced by what we perceive as the context in which we act.


• When a story does not fit it is useful to explore other context to which client could be connecting

• Bateson (1972) noted three significant contexts that operate within every conversation: – The context of time– The context of the definition of the relationship– Context of place

• Therapy is a very specific time and place and relationship

THE CHANGES TO THE CORE MILAN PRINCIPLES: CURIOSITY TO SELF-OTHER-REFLEXIVITY

Chapter 5: from neutrality and curiosity to self – other – reflexivity

the changes to the core Milan principles: Curiosity to self-other-reflexivity

• CECCHIN (1987) Hypothesizing, Circularity, and Neutrality Revisited: An Invitation to Curiosity.

• This seminal article moves away from the idea of “knowing”, to developing curiosity to question prejudice, and reflect on the recursive nature of the three elements in therapy


• If we are curious, we question premises: our own and those of the family we are treating.

• A family's interactions with us should facilitate questioning our own premises. Not only are we intervening in their systems, but families are also intervening in our systems: helping us to become better systemic thinkers.

• The idea of a recursive relationship among neutrality, hypothesizing, and circularity proposes a framework that invites us to be more curious about symptoms in therapy those of families as well as of therapists.


• By remaining curious we can never be certain because there’s always more to descriptions, connections and interactions going on that we are not aware of in the client’s life.

• This is the stance of perpetual doubt and not knowing

• Curiosity encourages the therapist to remain puzzled and questioning

• It allows us to be self reflexive on our theories prejudices and stories in our work with clients.

CIRCULAR QUESTIONING

Brown (1997) Circular questioning: an introductory guideHedges (2005) Chapter 6 circular questioning

Circular Questioning

• Circular questioning enables therapist to enter the interpersonal systemic frame

• Otherwise known as “relationship questions”• The use of Genograms can help map the

individual’s relationships in the absence of family.

• Add significant friends professionals relationships which are influential

Circular Questioning

• Include information known as SOCIAL GRRAACCCES:– Gender, race, religion, age, abilities, class, culture,

colour, ethnicity and sexual orientation• Information is difference: difference is a

relationship• The goal is to help clients notice change and

difference over time in order to draw distinctions. Circular questions target perceptions of difference not facts.

Language is linear

• Because the language is linear it creates the idea of cores – effect

• Language distinguishes between a subject and object: person who performs the action and the person who receives the action; creates an assumption that the world is organised in a linear way.

• Replace the verb to be with the verb to show: “appearance is not necessarily reality”

• Hypothesise about what the motion/behaviour shows as a communication and the meaning of this. Avoid intra psychic explanations

What circular questions do• Circular questions enable therapists to think relationally and therefore

systemically, thereby developing new connections. They:– Broaden the frame from the individual to interaction– Shift from “linear” cause-effect to interaction– Demonstrate the importance of relationship– Bring forth unheard-of voices– Make connections between the meaning of important events– Make links between present, future hopes and past stories– Keeps therapist curiosity alive– Help the client become more curious about their life– Enable us to test out and refute hypotheses– Introduce difference– Open space for new connections– To respect the client as an expert in their life– Facilitate changing the story

Circular/Relationship Questioning

• Seeks information about differences between:– People: “who notices most when I feel low?”– Behaviour: “who is most rude, John or Mary?”– Events: “did John do more around the house

before he got promotion or before you were at home or?”

– Relationships: between all the above

Individual systemic therapy approaches.

• Solution focused therapy• Narrative Therapy• Emotion Focused Therapy (EFT)

Technology

Lecture 6 systemic therapy with individuals