Comparing qualitative research methodologies for systemic research: the use of grounded theory, discourse analysis and narrative analysis

Many of the qualitative research methods developed in the social sciences are well suited to explore research questions pertinent for the systemic field, and make a good fit with systemic thinking. In this paper I briefly outline the value of qualitative research for systemic psychotherapies. I explore some parallel developments in the field of qualitative research and systemic therapy which can inform each other. Three qualitative methodologies, a grounded theory approach, discourse analysis and narrative analysis, particularly useful for the research of subjective experience and meaning, are briefly outlined. To compare and contrast these methodologies, I discuss their application to a pilot study concerning the experiences of living life in more than one language. I demonstrate how each research methodology can highlight different aspects of qualitative research material and address different research questions. The challenge of how these methodologies may be further developed for systemic research is posed.     

Intensive care units: a systemic perspective

There are no systemic accounts of Intensive Care Units (ICUs) nor is there much to guide the systemic therapist working within these units. This paper attempts to develop an analysis of ICUs and proposes two working models describing the various levels at which the therapist can intervene.     

Noogenesis—the fundamental problem of our time

The possibility of long wave economic cycles are considered under both market capitalism and command socialism. Capitalist long waves can be generated by a two‐stage multiplier‐accelerator model and socialist long waves can be generated by an equivalent model strictly for investment cycles. Under certain conditions chaotic dynamics can occur at turning points in both cases. It is argued that a systemic crisis leading to a systemic transformation is most likely to occur at such a point.     

Impaired memory consolidation in rats produced with beta-adrenergic blockade

Despite abundant evidence that systemic administration of adrenergic drugs and hormones can produce retrograde memory enhancement, the literature contains no clear demonstration that postlearning systemic administration of adrenergic antagonists produces retrograde amnesia. Here we demonstrate retrograde amnesia for a stressful learning task (a spatial water maze) with systemic administration of the beta-adrenergic antagonist propranolol (5 mg/kg). The amnesic effect of the drug depended on the degree of learning in the subjects: Propranolol caused a robust retrograde amnesia in "good learners," but did not significantly affect memory in "poor learners." The findings provide critical additional support for the hypothesis that postlearning adrenergic activation modulates memory consolidation processes after emotionally stressful events and help explain previous failures to detect memory impairment after systemic administration of adrenergic blocking drugs.     

The Relevance of Systemic Thinking to Student Counselling

After outlining the predominant approaches which currently inform student counselling a case is made for adopting a developmental systemic paradigm, locating individual difficulties within the context of a family dilemma. The view is taken that family systems thinking and individual approaches can be complementary and that systemic work need not be restricted to formal family therapy and the technology this implies.     

Career assessment and creativity: potential complementarity or a contradiction in terms?

ABSTRACT

In this research we investigated whether creativity and career assessment are a contradiction in terms or whether, through creative thinking, their potential complementarity in career guidance and counselling can be realised. The research demonstrates the creative application of the systemic Integrative Structured Interview (ISI) for the Self-Directed Search (SDS) with a South African female mid-life career changer. Results indicated that the ISI positions clients as storytellers who create rich systemic stories about their quantitative SDS scores. The constructs of story telling are evident throughout an interview about quantitative scores; the scores become unifying themes across the stories. In sum, the ISI can assist mid-life career changers to make meaning of their career transition; and by embedding career assessment in a systemic story telling process creativity is evidenced as a multilayered process.     

双源 CT 低剂量 Flash 螺旋模式在全身大血管成像中的应用

评价双源 CT 低剂量 Flash 螺旋模式全身大血管成像的图像质量和辐射剂量,探讨其应用价值。收集我院行双源CT 低剂量 Flash 螺旋扫描全身大血管患者69例（全身大血管 CTA 组）,行相同扫描范围的平扫患者69例（对照 A 组）,行回顾性心电门控螺旋扫描冠状动脉患者69例（对照 B 组）。比较全身大血管 CTA 组与对照 B 组的图像噪声及全身大血管 CTA 组与对照 A 组、B 组的辐射剂量。结果发现,全身大血管 CTA 组颈总动脉、颈内动脉、肾动脉、腹主动脉的图像质量均可满足诊断要求,图像噪声与对照 B 组比较,差异无统计学意义（Z＝-0．42,P＞0．05）。全身大血管 CTA 组有效剂量低于对照 A 组、B 组（Z＝-10．14;Z＝-8．76,P 均＜0．001）。全身大血管 CTA 组平均扫描长度短于对照 A 组（Z＝-8．86,P＜0．001）。故本研究认为,双源 CT 低剂量 Flash 螺旋模式安全、无创、快捷,图像质量高,大范围 CTA 成像的辐射剂量低,是一种适合全身大血管检查的影像技术。     

Self‐supervision,surveillance and transgression

Transgression is not only an inevitable part of systemic supervision but is also necessary if we are to work towards innovative and inclusive supervisory and therapeutic practice. Defying culturally generated ‘rules’ of systemic practice can allow for more relevant and productive ways of talking. Systemic practitioners are increasingly finding themselves trying to practice systemic therapy in employing authorities and training courses which are dominated by inflexible professional narratives and manualised procedures. Our profession is committed to ethical inner and outer dialogue, to self‐ and relational reflexivity as distinct from the rule‐bound surveillance culture in which we live and work. Systemic supervisors and therapists may find themselves at odds with monological institutional discourse and attempts from within our own profession to manualise practice. I introduce examples from supervisory conversations to illustrate how supervisors can develop more culturally sensitive practices through supporting practitioners to hear and have heard their own marginalised and oppressed voices and those of their clients.     

The Development of Systemic Family Therapy for Changing Times in the United Kingdom

In sketching the position of couples and family therapy and systemic practice in the United Kingdom of Great Britain and Northern Ireland (the UK) we have provided what we can of the development of the contexts of training and practice; the content of some of the theories and their applications; and the external realities within which we currently operate. The UK has a well developed structure for training and practice in systemic couples and family therapy. The history is of enthusiastic adoption of therapies from international sources which are generally then incorporated into an overarching systemic framework. Family therapy in the UK is currently subjected to a variety of pressures but is well regulated and is in a strong position to continue making its contribution to the welfare of families.     

The madman theory of war: a possible application in therapy

In therapeutic work a systemic approach has characteristically focused on the family or marital system. In this paper the author focuses on the patient/health care system in a particular case and argues that chronic disability can be seen as a systemic feature rather than a characteristic of the individual patient. A strategy is taken from the field of international conflict and its therapeutic value is explored.     

Impaired Memory Consolidation in Rats Produced with β-Adrenergic Blockade

Despite abundant evidence that systemic administration of adrenergic drugs and hormones can produce retrograde memory enhancement, the literature contains no clear demonstration that postlearning systemic administration of adrenergic antagonists produces retrograde amnesia. Here we demonstrate retrograde amnesia for a stressful learning task (a spatial water maze) with systemic administration of the β-adrenergic antagonist propranolol (5 mg/kg). The amnesic effect of the drug depended on the degree of learning in the subjects: Propranolol caused a robust retrograde amnesia in “good learners,” but did not significantly affect memory in “poor learners.” The findings provide critical additional support for the hypothesis that postlearning adrenergic activation modulates memory consolidation processes after emotionally stressful events and help explain previous failures to detect memory impairment after systemic administration of adrenergic blocking drugs.     

Using Contextual Therapy to Treat Depression with Couples

Abstract

Though depression is one of the most common presenting problems treated by systemic therapists, there have been relatively few attempts to describe how specific systemic therapy models can be applied to treat couples dealing with depression. In this paper, we discuss how contextual therapy can be used to treat depression in couples therapy. We identify multidirected partiality as an intervention and as a characteristic. We introduce letter writing and internalized other interviewing as contextual interventions that help to facilitate partiality and understanding between clients. A clinical vignette illustrates our discussed concepts.     

The central nucleus of the amygdala; a conduit for modulation of HPA axis responses to an immune challenge?

Physical stressors such as infection, inflammation and tissue injury elicit activation of the hypothalamic-pituitary-adrenal (HPA) axis. This response has significant implications for both immune and central nervous system function. Investigations in rats into the neural substrates responsible for HPA axis activation to an immune challenge have predominantly utilized an experimental paradigm involving the acute administration of the pro-inflammatory cytokine interleukin- 1β (IL-1β). It is well recognized that medial parvocellular corticotrophin-releasing factor cells of the paraventricular nucleus (mPVN CRF) are critical in generating HPA axis responses to an immune challenge but little is known about how peripheral immune signals can activate and/or modulate the mPVN CRF cells. Studies that have examined the afferent control of the mPVN CRF cell response to systemic IL-1β have centred largely on the inputs from brainstem catecholamine cells. However, other regulatory neuronal populations also merit attention and one such region is a component of the limbic system, the central nucleus of the amygdala (CeA). A large number of CeA cells are recruited following systemic IL-lβ administration and there is a significant body of work indicating that the CeA can influence HPA axis function. However, the contribution of the CeA to HPA axis responses to an immune challenge is only just beginning to be addressed. This review examines three aspects of HPA axis control by systemic IL-1β: (i) whether the CeA has a role in generating HPA axis responses to systemic IL-1β, (ii) the identity of the neural connections between the CeA and mPVN CRF cells that might be important to HPA axis responses and(iii) the mechanisms by which systemic IL-Iβ triggers the recruitment of CeA cells.     

Should I give advice? A systemic view

Giving advice is considered from i he viewpoint of Milan systemic family therapy, and the possibility of its always being a therapeutic error is discussed. The beliefs of both professionals and clients concerning advice are examined. What can systemic therapists do if families ask for advice, and when is direct advice useful? Effects on therapists and families of giving advice are discussed as well as ways of limiting possible damage to the process of therapy. Questioning techniques are considered as an alternative that allows families to discover their own solutions.     

晚期乳腺癌外科治疗的时机与个体化选择

IV期乳腺癌是难以治愈的疾病,治疗方法是综合治疗,目的是缓解症状、改善生活质量、延长生存期。外科治疗作为综合治疗的一部分,对手术切除Ⅳ期乳腺癌原发灶或转移灶的临床意义和手术时机存在争议,本文结合文献从哲学的角度分析讨论Ⅳ期乳腺癌是否需要外科处理。认为Ⅳ期乳腺癌全身治疗和外科治疗是治疗过程中矛盾主要方面和次要方面的关系,可互相转化,两者作用相辅相成,当全身治疗病情缓解时,个体化选择外科治疗不仅改善生存质量,还可能提高生存率。     

The limits of systems therapy: The problem of intimacy

By placing so much emphasis on systemic thinking, marriage and family therapists have lost sight of the individual within the system. One of the limits of a systemic therapy is its capacity to deal with problems in intimacy, a central problem in marital therapy. A knowledge of individual development is crucial for family therapists. The two themes dealt with in this paper are 1) some concepts of self psychology which can be useful in understanding the fear of intimacy, and 2) at what point, in couples' therapy, it is advisable to shift to individual therapy for one or both partners.     

Links between attachment theory and systemic practice: some proposals

This paper considers some of the current thinking in relation to attachment theory and systemic theory in understanding the development of adult couple relationships in terms of their attachment to each other and of their adaptations as a family. There is an increasing interest in adults' attachments to their own parental (attachment) figures, how these have an impact on the attachment relationship they have with their own children, and to the idea that adult partners can become attachment figures for each other with the potential for development being lifelong. Discussion focuses on attachment issues within the family group and the relevance of these to systemic practice.     

Looking at Systems as Process

This article proposes that the social systems family therapists are concerned with may usefully be conceived of as interactive processes. It discusses limitations to the organismic view, in which social systems are seen as autonomous entities with boundaries, internal structures, and self-perpetuating behaviors, and argues, from Maturana and Varela, that social systems are qualitatively different from organisms. It develops from chaos theory an alternative view in which social systems are seen as complex nonlinear processes. It proposes that this view can free the therapist from the notions of family dysfunction and the systemic function of symptoms, and from reifications in which the family is seen as having covert rules, keeping secrets, neutralizing the therapist, and the like. This view leads to a redefinition of the therapist's place in the system and to the conclusion that family therapists can only influence systemic process by working with individuals.