The listening heart and the chi square: clinical and empirical perceptions in the family therapy of anorexia nervosa

Clinical and empirical methods are commonly considered to be complementary activities. However, many people in the fields of mental health and social welfare espouse a strong adherence to experimental, scientific methods for the evolution of theory and practice and consider only that which has been experimentally tested as‘really true”. Others would propose the clinical method as the main source of useful knowledge and are suspicious of enumeration and quantification as sources of useful information. Formal, empirical methodology is well and extensively described whilst there is less systematic exposition of the clinical method. Family therapy evolved in a context in which activity was visible and the emerging discipline was propelled by a theoretical framework with strongly scientific origins that was critical of the exclusive clinical method of pre-existing psychotherapies. This paper describes some of the clinically based contributions to the family therapy of anorexia nervosa and compares this information with that which comes out of the Maudsley trials of psychotherapies in anorexia nervosa.     

Being a therapist in eating disorder treatment trials: constraints and creativity

This paper gives a brief overview of the sequence and content of the eating disorder treatment trials at the Maudsley Hospital in London, and describes the experience of the author working as a research therapist on these trials. It considers the different ways research constraints affected the therapist, how she learnt to make creative use of what appeared to be therapeutic restrictions, and how having her clinical freedom curtailed taught her to be more flexible and showed her new ways of understanding her patients.     

Stories for therapy: The right story to the right person at the right time

In the postmodern information era with its increasing complexity and demands on my time, I find storytelling increasingly attractive. The right story told to the right person(s) at the right time in the right way can powerfully define and shape both individuals and the systems into which they organize themselves. As interventions go, I find stories to be relatively high impact, low-risk, parsimonious, and user-friendly. This paper contains some of my favorite teaching stories and describes why and how I use them as both a family therapist and teacher of family therapy.     

The self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.     

“Not with me you don't”: A story of narrative practice and dissociative disorder

This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room.     

The recovering female alcoholic: A family affair

Supported by a review of relevant literature and a case study, the author argues that family therapy intervention enhances the likelihood of a female alcoholic's positive prognosis. With a basis in systems theory, family therapy views the family as a system and, hence, perceives the alcoholism as a symptom of that family. A profile of the female alcoholic, how her drinking affects her family, and the role that family therapy plays in the recovery process are examined.     

Toward culturally sensitive intervention with arab families in Israel

Over the past three decades, Arab society in Israel has been undergoing processes of transition. These processes are manifested by changes in the economy, education, the status of women, family structure, and by socio-cultural changes and transformations in patterns of coping with social problems. There is a serious lack of empirical research on the implications of this process for the value systems of Arab society and families in Israel and a dearth of relevant intervention-oriented literature. This article outlines the basic cultural values in the Arab society in Israel in an attempt to illuminate the relevance of these values for family structure and for direct interventions with Arab families in Israel.     

Art in existential psychotherapy with couples and families

The authors describe and outline how art can be used in existential psychotherapy to help a couple or family uncover, discover, and make use of the meanings and meaning potentials to be found in marital and family life. In existential psychotherapy with couples and families, art can be used to help the members of the relationship notice meaning potentials in the future, honor meaning potentials that have been actualized and deposited in the past, and discover new ways to actualize meaning potentials in the here and now.     

The role of theory in treating adolescent substance abuse

The adolescent substance abuser, like adult addicts, is most commonly considered from the perspective of the disease model. The usefulness of the disease model in conceptualizing adolescent substance abuse is questioned, and an alternative view of the topic is set forth. Substance abuse, is regarded as an adaptive aspect of the ongoing interactive processes within the family. The developmental process of the adolescent substance abuser is seen as a functional dynamic in the family's preservation. Three characteristic elements of parental interaction common to the development of adolescent substance abuse are highlighted.An earlier version of this paper was presented at the Texas Association for Marriage and Family Therapy annual conference on January 28, 1993 in Houston Texas.a research associate and director of the Don D. Jackson Archive at the Mental Research Institute, Palo Alto, CA. Authors are listed alphabetically.