Martin Buber and psychotherapy

This paper is intended to make the ideas of Martin Buber more directly available to psychotherapists. Buber's influence on therapy is mostly indirect and the author believes that his impact could be considerable if his writings were better known and more often discussed. Several important ideas of Buber are summarized. These include dialogue, I-Thou relationships, existential guilt, and confirmation.     

Science and Family Therapy

Family therapists are being exhorted to adopt a social constructionist epistemology and to abandon science as a valid form of knowing. Epistemological objections to science are usually directed at 'positivism', an outmoded view that is largely discredited among practising scientists. Contemporary science, is rather, constructionist, differing from other constuctionist approaches only in ways of arbitrating between world views. Criticisms aimed at science apply to all forms of discourse, including family therapy. I conclude that science has failed family therapy at the practical, not the philosophical level.     

Is there a place for individual subjectivity within a social constructionist epistemology?

The epistemological turn towards social constructionism has become well established within the field of family systemic therapy. Social constructionism has provided therapists with a theoretical rationale for the concentration upon the social context within which individuals and families live their lives. This is a philosophical position that pushes to the margins the positivist premise that individuals have fixed and measurable personalities in favour of a discourse which proposes that the person is encountered differently within different social contexts. Prompted by the growing interest in systemic practice with individuals and by the rediscovery of the psychoanalytic canon within family therapy literature, the adequacy of this position is examined and an attempt is made to open up a space within social constructionist discourse for a theory of individual subjectivity. Findings from a research project are the starting point for this venture. These findings are understood through the lens of psychoanalytic theory, with particular reference to the work of Jacques Lacan.     

Healing relationships and the existential philosophy of Martin Buber

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core.     

UNPACKING ESSENTIALISMS IN THERAPY: LESSONS FOR FEMINIST APPROACHES FROM NARRATIVE WORK

The narrative approach to therapy founded by Michael White and David Epston offers important contributions to feminist constructionist therapies. Feminist and narrative ideas in the therapy world often challenge essentialist, or naturalized, understandings of gender. However, both forms of therapy, at times, retain essentialist elements which often prove to be problematic. This article shows how certain readings of--and new directions in--narrative therapy allow for an effective approach to lingering essentialisms in constructionist therapies, both feminist and narrative. At the same time, and in keeping with the goals of feminist therapy, narrative practitioners do not fall into an anarchical or radically relativistic perspective on the self or social life. The conclusion suggests that narrative ideas about unpacking essentialisms provide insights for constructionist theories of identity, culture, and power that apply to a number of different disciplines.     

Bilingualism and systemic psychotherapy: some formulations and explorations

Bilingualism has risen dramatically due to increased migration patterns all over the world. This paper offers an overview of the current literature dealing specifically with bi- and multilingualism, and identifies a gap in systemic and family therapy literature about the subject of bilingualism. In the light of this, the author proposes a working definition of bilingual families. Some case examples illustrate different aspects of working systemically with a bilingual family and highlight potential challenges for a therapist, such as the assumption of more knowledge and expertise. The tools suggested relate to a rethinking of some modernist ideas regarding hypothesizing, and both the use of a social constructionist perspective and of self of the (bilingual) family therapist. A case is made for the exploration of meanings of difference including the lingua-cultural one. The author ends with a plea to start including more specific cultural issues such as bilingualism in systemic therapy practice.     

Notes for a cultural history of family therapy

The official history of family therapy describes its beginnings as a daring technical and philosophical departure from traditional individual treatment in the 1960s, inspired especially by the "system thinking" of Gregory Bateson. This celebrated origin story needs to be supplemented with a longer and larger history of both practice and thought about the family, and that is the subject of this article. The longer history goes back to the founding of social work by Mary Richmond, of pragmatism by William James, and of the organic view of social systems intervention by John Dewey. Seen against this background, family therapy is, among other things, a consequence of the development of persistent elements of American professional culture, experience, and philosophy. The taking of this historical-anthropological view discloses also the origins of two other histories that have made their contribution to the development of family therapy: a science of observing communication processes that starts with Edward Sapir and leads to contemporary conversation analysis, and a history of mesmerism in the United States that culminates in Milton Erickson and his followers.     

Family therapy and anthropology: a case for emotions

The idea that emotions are socially constructed challenges traditional views in both family therapy and anthropology and also opens the possibility for further collaboration. This paper reviews the traditional position of orthodox family therapy theory with respect to motivation and emotions. It argues that a social constructionist position can build on original family therapy insights about the connectedness of family members and offer a view which transcends mind-body dualism. Bateson's concept of ethos is seen as a forerunner of this view and, with the increasing interest in meaning and cross-cultural issues, Bateson's ideas deserve renewed attention. Implications of a social constructionist view of emotions for family therapists are outlined.     

Evaluating Therapists' Practices in a Postmodern World: A Discussion and a Scheme

The social constructionist ideas currently reshaping the practice of family therapy are also relevant for supervision. However, if, as postmodernists assert, there is no privileged, expert position, how can supervisors evaluate their trainees? This question — a most pertinent one for university-based supervision, where evaluation is necessary and constant — is addressed both theoretically and pragmatically in this article. Ethical issues are explored, and an evaluation form, developed by the authors for use in a family therapy doctoral program, is presented and discussed.     

Of Families and Other Cultures: The Shifting Paradigm of Family Therapy

This essay proposes that family therapy is currently undergoing a paradigm shift as a result of the ascendance of an epistemological focus absent in the foundational works that gave rise to the field's dominant clinical approaches. While systemic metaphors for the family are based on mechanistic, biological, and linguistic models primarily concerned with how the world is (ontology), postmodernism's social constructionist leanings give primacy to meaning, interpretation, and the inter-subjectivity of knowledge (epistemology). Thus, the metaphor of the family as a system is gradually being subsumed by a metaphor that construes families as interpretive communities, or storying cultures. It is suggested that this largely implicit transformation be made explicit in order to explore more fully the clinical implications of the new epistemology.     

Traps for Sacrifice: Bateson's Schizophrenic and Girard's Scapegoat

John Perceval (1803–1876), who suffered from schizophrenia, published two books on his experience, in 1836 and 1840. More than a century later, the anthropologist Gregory Bateson discovered in Perceval's memoirs a lucid anticipation of his own theories on schizophrenia. To Bateson, Perceval describes the interactive patterns between himself, his family, and the hospital psychiatrists, as examples of “double bind” interactions, in which he played the role of a “sacrificial victim.” The article underlines the strong convergence between Bateson's theory of schizophrenia and René Girard's theory of the scapegoat. In the anthropological theory of Girard, the sacrificial ceremonies are the main way of constructing social order. In that perspective, the schizophenic can be considered as a particular example of a scapegoat, that is, as an important figure in social life, and not as a mere phenomenon of psychopathology. This theoretical convergence is remarkable, in particular, because both anthropologists explain the sacrificial processes through a theory of social life based on the idea that the main unit of analysis is not the individual, but the interactive dynamic as a whole: patterns of relationships, to Bateson; reciprocal imitation (mymesis), to Girard.     

Narrative Child Family Therapy

In this article, child family therapy is presented as a hermeneutic activity shaped by an interest in the evolving narrative. Over brief, analytic play interviews, the therapist documents a child's narrative understanding of the presenting family problem. This allows psychological meaning to be jointly constructed in therapeutic conversation with the child and family. The idea of play as narrative integrates child psychotherapy into recent social constructionist thinking in family therapy. The article also discusses how narrative therapists can use prior theory and training.     

Valuing Ideas of Social Justice in MFT Curricula

Training programs committed to the development of culturally sensitive family therapists must support dialogue that creates awareness of social structures promoting inequity and oppression. In order to facilitate meaningful conversations about issues of social justice educators have to critically examine their own philosophies and teaching methods to create a learning environment that promotes this dialogue for all students. This article outlines our philosophy of teaching and presents two core MFT graduate courses as examples of how issues of social justice can be valued in the didactic component of marital and family therapy (MFT) training.     

The real as illusion: deconstructing power in family therapy

This paper examines the current issue of power and intervention in family therapy from the perspective of Jacques Derrida's philosophy. In a deconstructive reading which presents power as both real and socially constructed, it negotiates the border between such dualities as knowing/ not-knowing, intervention/non-intervention, and power/non-power. The paper tracks Goolishian and Anderson's approach to therapy as deconstructive in practice, but not in theory, and discusses a double view of power in relation to both Bateson and Foucault. It suggests that power is both endemic to the context of family therapy and an illusion of epistemology. The paper concludes with a discussion of the wider question of ethics in relation to technology.     

Toward a relational perspective of the psychology of careers and working: A social constructionist analysis

This article explores the contributions of social constructionist thought to the development of a relational approach to careers. In this article, the term “careers” is defined as encompassing the working lives of all individuals. Using a social constructionist perspective to critique existing assumptions about careers, work, and relationships, the authors develop a conceptual framework that expands the theoretical opportunities inherent in a relational approach to the study of careers. The article concludes by highlighting implications of a social constructionist analysis of a relational approach to careers for theory development, research, practice, and public policy,     

African and Islamic philosophy: Expanding the horizons of philosophical counselling

Philosophical counselling has traditionally utilized a limited number of philosophical traditions: Existentialism, Stoicism, and the employment of Socratic dialogues being the most common ones. Focusing on a limited number of philosophical views does not exploit the potential therapeutic value of many other philosophical traditions, and may enhance dogmatism. In this paper we illustrate the need for a wider philosophical toolkit by showing the potential value of two rarely-employed philosophical traditions: African and Islamic philosophy. From the plethora of issues in these philosophical traditions, we highlight the relevance of African philosophy to conflicts between social duties and individual desires, and the relevance of Islamic philosophy to conflicts between faith and reason. We then emphasize the relevance of these philosophies in the current social and political situation in the Western world in general, and in Europe in particular.     

Turning differences into possibilities: Using discourse analysis to investigate change in therapy with adolescents and their families

Discourse analysis affords researchers and practitioners improved understandings regarding how positive outcomes are accomplished in the conversations of family therapy. By investigating how change is constructed or ‘performed’ in therapeutic interactions, its analyses conceptually parallel those of the social constructionist approaches to family therapy. In this respect, discourse analysis offers empirical methods to examine claims about the constructive aspects of therapeutic conversations. These conceptual and research parallels are examined in how impasses in family therapy were transcended, rhetorically, between an adolescent, his parents and the therapist. We conclude that the research methods of discourse analysis can directly enhance the conversational skills and methods of therapists.     

A narrative social constructionist approach to therapeutic empathy

The concept of empathy has been a centrol conceptual element in approaches to counselling and psychotherapy that emphasise exploration of meaning in the context of a facilitative relationship. However, the existing literature on therapeutic empathy lacks theoretical coherence. a narrative social constructionist perspective represents a theoretical approach that enables the integration of diverse strands of clinical observation and research into the creation of empathic understanding in counselling. From a social constructionist position, therapeutic empathy can be understood as a relational process, a step-by-step co-construction by counsellor and client of the life-narrative of the client. In this paper, the Barrett-Lennard (1981) cyclical model of empathy is used as a fremework for examining the counsellor and client actions, strategies and tasks that constitute empathic engagement around the task of emploring and re-authoring life-narratives. Constructionist analysis of the cultural origins of the concept of empathy suggest some limitations of this way of conceptualising what happens in therapy. The implications of these ideas for theory, training and research are discussed.