Innovations in the Reflecting Process

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'The passion to continually be on the move to seek new understanding is a characteristic of the field of family therapy and systemic thinking over the last forty years. Many professionals have moved around, more or less freely, in and out of this field. Some have made footprints that will last for a long time. One of these is Tom Andersen. From a position as professor in social psychiatry at the University of Tromso in northern Norway he has moved around the world participating with other professionals in their efforts to develop their work and seek wider horizons.' - Harlene Anderson and Per Jensen, from the Preface

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1. Practising “withness”: a human art

ePub

Lynn Hoffman

Ihad been to the North of Norway on numerous occasions, mostly at the Summer Solstice, but Tom Andersen kept telling me that I must come in the “Darktime”. So he invited me for the first day of spring, just as the sun was going to appear. Tom took me to his top-floor office at the University of Tromsø the morning of the conference, and out the window I saw the first rays. They appeared in the cleft of two snow-covered mountains, then faded away, followed by colours of pink, mauve, and gold that lit up the edges of landscape and sky.

From time to time as I have passed through the history of this field, I have been given the chance to see such first rays. And I have in some way known or guessed which newcomer approaches would establish themselves and persist. One is taking shape now, like a ship hull-up on the horizon and coming closer. Roger Lowe (2005), in a recent article, has referred to it as the “Conversational” or “Dialogical therapies”. More interesting, perhaps, Lowe distinguishes between “Structured-Question” approaches, like Narrative (White, 1995) and Solution-Focused (de Shazer, 1994) work, and what he calls, following John Shotter (Shotter &Katz, 1998), a “Striking Moments” approach. By this description, we seem to have discovered a territory that relies on a relational version of static electricity for its effects rather than a technology that is imposed from outside. Using this new measure, the Collaborative perspective of Harry Goolishian and Harlene Anderson, and the Reflecting Process of Tom Andersen, are being joined by a new band of travelling players who have related, but different, songs to sing.

 

2. “Reflecting talk”, “inner talk”, and “outer talk”: Tom Andersen's way of being

ePub

John Shotter &Arlene Katz

“The listener (the therapist) who follows the talker (the client), not only hearing the words but also seeing how the words are uttered, will notice that every word is part of the moving of the body. Spoken words and bodily activity come together in a unity and cannot be separated.”

Tom Andersen (1996, pp. 120–121)

“The listener who sees as much as he or she hears will notice that various spoken words ‘touch’ the speaker differently. The speaker is touched by the words as they reach his or her own ears. Some words touch the speaker in such a way that the listener can see him or her being moved.”

Tom Andersen (1996, p. 121)

“Sometimes a sentence can be understood only if it is read at the right tempo.”

Ludwig Wittgenstein (1980, p. 57)

We feel honoured to have been asked by Per Jensen and Harlene Anderson to contribute to this Festschrift for Tom Andersen on his 70th birthday. Tom’s work has not only been extremely influential out in the world of psychotherapy in general, but also on and in our individual lives. Over the past twelve years or so, as we have struggled to understand and to articulate in more explicit detail the living micro-dynamics of therapeutic processes, it is Tom’s way of talking and listening—his very way of being with the people he cares for in a therapeutic setting—that has been there for us as a working exemplar of what seem to us to be at least some of the crucial features of a therapeutic way of being with those in need of such care.

 

3. Creating a space for a generative community

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Harlene Anderson

Meeting Tom Andersen and the Scandinavian community that he introduced me to has been a life privilege. The first time that I remember seeing Tom was when he walked into the hotel ballroom where we (my colleagues at the Houston Galveston Institute) were convening the Epistemology, Psychopathology and Psychotherapy Conference in 1981. Eagerly watching to see who was joining us, Tom stood out from the crowd entering across the room. With his tallness, abundant brown curly hair, and stripped sack-like shirt, he had the look of a “foreigner”. It would be a few years later before I had the chance to really “meet” him, when immediately Harry Goolishian and I felt an affinity and felt that we had found a kindred soul. The colleagueship and friendship that grew over the years was so welcoming in those days, when Tom’s ideas and those that Harry and I were talking and writing about were often rejected and discounted by others. We were on similar paths, sometimes paralleling and sometimes meeting. The views and interests that served as the beginning common bond have evolved and over time have inspired and linked therapists around the world who form a generative learning community. Though I have known of Tom’s global influence, it was not until I read the chapters in this book that I realized how it had spread creatively far beyond the therapy room.

 

4. Flashbacks in war: a consultation with reflections

ePub

Peggy Penn

There are things we love and preserve out of simple familiarity; sometime it is beauty or an idea like the ethics of entitlements. In my case, I love a meadow. My daily walks take my husband and me to the top of a hill where a particular meadow stretches out in front of us. I know it’s been there long before we knew it. I heard that someone had leased it and cut down a magnificent grey beech; I felt bereft. Walking by, I see how it resembles an elephant’s graveyard, with huge severed trunks and branches big as legs, lying in a heap, their raw, yellow ends, splintering. It was as though poachers had done this and, to diminish the tree even more, would readily turn this pile of limbs into ashtrays. However, I seem to have many discontents: this is only one, Israel is another.

I am never simultaneously so happy and so sad as when I am in Israel; I never cry so much or laugh so much. It is the people who move me to such extremes of feeling, the people who exist in this state of war. I am moved by the sweetness of their green land and how they formed it out of every handful of dry earth, and the justice they constructed after the Holocaust. A land of their own not to run from; but, paradoxically, the terror of death remains.

 

5. Voicing voices

ePub

Adela G. García &Lino Guevara

We would like to share a story about encounters and conversations, about a journey we embarked upon together, first in the field of clinical family therapy and training, and more recently in social contexts that include larger systems. We have been working together in Buenos Aires, Argentina, since 1997. Our paths first crossed after our own individual journeys in the world of psychiatry, psychology, and psychotherapy, including immigration as well as emigration. From the beginning, there were coincidences in our clinical work as well as a common interest in society as a whole. We went from modern persuasion to postmodern uncertainty, from emphasis on interventions to an approach that favours open conversations and reflecting processes in which questions and listening are honoured. It is the way one speaks that affects conversations.

This is where Tom Andersen’s voice, through his writings as well as his personal yearly visits to Buenos Aires, comes in and has since been accompanying us on our journey. The fashion in which reflecting teams and reflecting processes promote more equity in client–therapist, supervisor–supervisee, teacher–student relationships is essential to us, as is the inclusion of multiple perspectives and voices. We share with Tom the idea that open and reflecting conversations promote a language of solidarity and, therefore, also a language of democracy. We would like to use this opportunity to relate some of our experiences in the larger social contexts where these concepts and practices have been of great help to us.

 

6. Open conversations that weave changes in contexts of poverty or wealth

ePub

Roxana Zevallos &Nelly Chong

Almost eighteen years ago, we initiated the challenge to spread a new way of thinking about the human problems in our environment and created the Instituto Familiar Sistémico de Lima (IFASIL), a postgraduate family therapy study centre. Since then we have been training systemic family therapists, or, as we say, training systemic operators, in different contexts: clinical, communal, educational, and so forth. We have also been working with families in varied contexts in our country. Although IFASIL is a private institution, through our training programmes and our links with the community we offer assistance to families of limited economic resources, who represent the extremes of our society.

One of our most famous writers, Ricardo Palma, author of Las Tradiciones Peruanas [Peruvian traditions], described Peru as a “mosaic” of cultures, flavours, and colours, in reference to the mixture of races and customs that characterize our country. Along with this, the economic, social, and cultural differences extend the mosaic to complex dimensions. Peru is a country where old and new customs coexist; where the fight against the poverty is an every- day struggle; and where unscrupulous politicians manipulate the “sense” of lack of opportunities (e.g., work, food, education, etc).

 

7. Conversation, language, and the written word

ePub

Judit Wagner

An abundance of thoughts can be conceived when we dare to be present, listen, and even step into these thoughts, as I aim to show in this chapter. I also show how individuals within the organization think, and how they are affected through an ongoing conversation. Some language expressions and how they influence our thinking are described, and I have chosen texts representing language expressions. I also describe how a written text can be used in different ways: as a way of beginning to talk or to tell a story, as one way to describe the other.

A place for conversation is created

I work in a prison in Kalmar, a city in the southeast of Sweden. The prison has a high security rating and houses sixty inmates who are serving long (twelve-year) or life sentences. Nowadays Kalmar is a drug-free institution, meaning that those placed there are not substance abusers. The prison has a school and a work- shop, where the inmates study or work. There is now an apartment within the facility grounds where the inmates can receive visits from their families and spend a few days together with them. A placement in Kalmar is centrally controlled by KVS (The Board of National Prison and Probation Administration), the highest deciding body for correctional facilities in Sweden. Most of the inmates have gone through a risk-assessment at Kumla Prison, a big institution serving the whole country, prior to their transfer to Kalmar. The assessment yields a psychological classification and diagnosis of the inmates’ capabilities, or, rather, their lack of capabilities. KVS also make reassessments of the inmates regarding decisions about when parole and relocation to lower-security facilities can take place.

 

8. Balancing between peripheral/central positions when we're invited to be central

ePub

Helena Maffei Cruz &Marília de Freitas Pereira

“How you balance between being significant and central and at the same time stay on the periphery is a challenge. How do you do this? What do you say to yourself? What do you say among yourselves [the team working together]? It is such an important balance and yet so difficult!”

These were the first remarks we heard from Tom Andersen when he visited the SASECOP project1 in October 2000. We were taking part in a team-building process with seven teachers, one psychologist, one social worker, one art therapist, and the administrator, aiming to offer more than just soup, bath, and bed to homeless people who were attending the shelter. The project’s objective was to promote inclusion through socio-educa-tional activities.

Tom’s description of our way of being with our clients, in that project and in training courses and family therapy, brought a new understanding to our actions: we remain peripheral in order to allow people autonomous actions, decisions, and solutions in situations they describe as problematic. We should say that we are actively peripheral because our central beliefs include Anderson and Goolishian’s ideas that “the client is the expert” (Anderson &Goolishian, 1992a). This chapter describes how we maintain a useful central/peripheral balanced position.

 

9. Celebrating moments of discomfort

ePub

Judy Rankin

Reflecting upon the influence that Tom Andersen has had on how I think about my life and work and how it has transformed or shifted my practice is a privilege. In this reflection I do not make formal reference to his written words but, rather, to the words I heard him say in the various workshops that I have attended and in the conversations that I have had with him. I stress that it is what I heard and what I wrote down. The words are not direct quotes (although I wrote down what I thought was verbatim), and they cannot be formally attributed to Tom. As in any dialogue, I cannot be sure that he said this. I heard what I was ready to hear, which is influenced by what I was bringing to the dialogue. His words (or the words I heard), as well as those of others, gave some form to my feelings of discomfort. As my practice involves teaching others, my journey through these moments of discomfort has had to be articulated and consciously reflected upon through the written word and through my teaching. This chapter has given me the opportunity to uncover and read notes from workshops over the years and reflect consciously on the influence of Tom Andersen on the form of my practice. I have used the words I heard Tom say to organize the chapter.

 

10. Networks on networks: initiating international cooperation for the treatment of psychosis

ePub

Jaakko Seikkula

On a visit to Falun in Sweden in June 1995, Tom Andersen, myself, and the local team working with psychotic patients got the idea of proposing a meeting place for psychiatric units that wanted to develop new, more humane practices in treatments for psychosis. Tom had been travelling around in different countries and in different psychiatric contexts and had encountered a shared need for an alternative to mainstream psychiatry. Mainstream psychiatry meant a treatment that focused on controlling psychotic symptoms and psychotic behaviour by heavy medication from the outset and by inpatient treatment for long periods. In Falun, the acute team had received interesting experiences after decommissioning a hospital ward for psychotic patients and organizing a psychosis team instead. In addition to the inspiration of Tom Andersen’s reflective processes, they had their inspiration from both psychodynamic individual psychotherapy, having as their supervisor Murray Jackson from the United Kingdom, and the need-adapted approach from Turku in Finland; they had met Professors Yrjö Alanen and Viljo Räkköläinen.

 

11. True stories: acts of informing and forming

ePub

Eugene Epstein, Manfred Wiesner, &Margit Epstein

“Not all I might say and do is acceptable for society.”

Tom Andersen (1995b, p. 31)

“The aspects of things that are most important for us are hidden because of their simplicity and familiarity.”

Ludwig Wittgenstein #129

Until now, nobody has asked us to tell the truth. So when we were asked to contribute to this book, we thought, truth be known, now is our chance. The three authors have been living and working in exile for more than a decade in a remote corner of northern Germany. Although the weather is abominable there, with cold wind and rain throughout much of the year, the winters are not nearly as dark and cold as they are in northern Norway. This is perhaps but one of the many important reasons why the authors have not been able to develop anything nearly as simple, radical, and aesthetically beautiful as Tom Andersen’s idea of “reflecting talks”. But what, might the reader ask, have “reflecting talks” to do with the authors? That is the beginning of this mostly true1 but, in any case, very personal story.

 

12. The June Seminars at the North Calotte

ePub

Magnus Hald, Eva Kjellberg, Anders Lindseth, &Pål Talberg

North of the polar circle in Norway, Finland, Sweden, and Russia lies the geographical area called the North Calotte. The area is vast, barren, and sparsely populated: people living there are often long distances from the central communities and hospitals. Tromsø is the capital of North Norway. A mental hospital, Åsgård, was established there in the early 1960s to provide psychiatric services in the Norwegian part of North Calotte. The hospital was planned to have more than four hundred beds to serve a population of two hundred thousand. Humanistic currents in psychiatry in the 1960s, together with the magnitude of the catchment area, contributed to some professionals at the hospital daring to try out new routes in forming the psychiatric treatment that could be offered. They travelled out into the districts and began to work in the local communities together with the ordinary local staff. This “outdoor work” paved the way for family therapy that reached Norway in the early 1970s to gain a good foothold in this part of the country. At first, strategic and structural therapy forms were central, but as time went on the “Milan-model” attracted a growing interest and became the starting point for the further development of the field in North Norway. Ideas about the significance of time and context in our lives became especially important. People change according to circumstances around them, and important parts of these circumstances consist of their family life and life in the local community.

 

13. Crossroads

ePub

Tom Andersen,
in conversation with Per Jensen

Practice comes first, says Tom Andersen. It is not easy to be a hierarchically oriented psychiatrist if one wants to be part of the reflecting team, he believes. Speaking less and listening more became an important crossroad in his practice. We met for a few hours one evening to speak about the important crossroads in Tom’s working life. I began by asking whether there are any special experiences that have come to mark important points of departure for him. “Experiences with contexts made a strong impression on me”, he says, and he relates two of many such episodes.

“For example, when I was a young regional doctor making house calls, I saw that family and neighbours filled the kitchen. They were there to show their concern and willingness to do something if it was wanted. When I came back to the kitchen after having examined the ill person, my ‘reports’ produced, as a rule, relief and joy, while sometimes the seriousness of the situation got even more intense. Another example is from the psychiatric hospital in Tromsø where people who were admitted often came from far away. Most became silent and quiet, and that touched me deeply, bordering on being unpleasant, to see how powerfully they longed for home. These are just two of many examples of how important it became to be reminded of and sensitive towards different contexts.”

 

14. “When it starts buzzing in your ears, you must lean forward!”

ePub

Knut Beine Lykken &Trygve Grann-Meyer

When honouring the birthday of important men and women, it is common practice to look back on their active working life and what they have accomplished. So we, who have known Tom David Andersen the longest, thought that it would be interesting in this short tribute to look at a little of the background of this complete man and person, TOM. Heredity and environment are, after all, the basic influences in life …

We who have known Tom since the first day at school soon noticed that there was something special about this boy. He was unique, a boy whom one always listened to. One could not ignore him.

The war years brought problems and sorrows for Tom and his family. Tom’s father was one of the teachers who was sent to forced labour in Finnmark by the occupying forces. But the war years meant that we experienced a community that was unique. Perhaps our friendships and our urge to go our own ways grew steadily stronger because of just that. We had no entertainment other than what we found for ourselves. Our play went far beyond that which we today find consistent with basic child safety.

 

15. Of course I knew everything from before, but …

ePub

Georg Høyer

It started with the professionals: a psychiatrist, a psychologist, two nurses, and a police officer. Then came the relatives, and after them the consumers. Small groups of five persons or fewer talking quietly among themselves about their experiences related to the use of coercion in the delivery of mental health services. No analysis, no interpretations, no messages; just stories. Very personal stories. What else? Over three hundred and fifty people in a huge congress hall, listening in silence. Deep silence.

The event took place in Oslo in May 2004. It was a conference called Coercion and Voluntariness in Psychiatry, and invitations were sent to all kinds of people interested in the subject. In the announcement, the conference was promoted as a “different conference”. And it was different. Here I try to share some of the experiences from the conference: why it turned out to be different, and why it is hard to forget it.

The idea was born sometime during 2002. Tom Andersen came to me one day and said that he had been thinking of arranging a conference addressing the use of coercion in the field of mental health care. Through his many contacts with consumers, consumers’ organizations, and relatives, he felt that the time was right for such a conference. And he particularly insisted on arranging such a conference in cooperation with the relatives’ national alliance. As I have known Tom since 1969, I knew I should trust his idea, even if I had some (unexpressed) doubts about the feasibility of such a conference. At the same time, it was a pleasant surprise that there was an interest in discussing the use of coercion; I have myself dedicated my entire academic life to the role of coercion in psychiatry, and for most of the time it has been very lonely. So I agreed to join. At least, I agreed to participate in the planning process and see how the work developed. In retrospect, it was a good decision for me, because the conference turned out to be a success far beyond my expectations.

 

16. A small “musical” greeting from “The Chamber Music Group, ”

ePub

Rebekka Alne, Heidi Susann Emaus, &Anki Godø
Giæver, together with Liv Marit Edvardsen,
Åsrun Gjølstad, Gry Årnes, Tone Vangen Fagerheim

We called our group Seven Sisters since we were seven women. All sisters of someone, most of us were even big sisters. Some of us were also sisters professionally, as “søster” is a Norwegian term for nurse. Now we were to meet frequently for two years in a study group with Tom Andersen and Fay Wilhelmsen as supervisors. In this rewrite we have chosen to call ourselves “The Chamber Music Group, Seven Sisters”, addressing here what the training in “relations and network collaboration” has meant to us.

This metaphor has possibilities and limitations, in similarity to all metaphors. Chamber music is played by small crews. Often the members of these small crews also participate in other and larger orchestras, just as we worked in our designated jobs and departments and were students on the side. Seven Sisters played instruments by repertory from three different professions. The instruments were well-tuned in advance, pure sounding after our several years of professional education, many more of practice, and by the combined experience of seven lives. By viewing ourselves according to the principles of chamber music, we see that the question of a common repertory probably was not present as a matter of course. However, after a great deal of practice we learned to improvise.

 

17. Thank you, Tom

ePub

Eva Albert

The day before I was asked if I would contribute with these words, I had for the first time in twenty years been interviewed while being observed by a reflecting team, and I felt I was back where it all started. Maybe it is not correct to use the word “started”. Let me say that I felt back in a setting where my interest in people, their lives and stories had been cultivated in a most inspiring and nourishing way.

Where and when and by whom was this? The answer is Tromsø in the 1970s, and the creator and cultivator was Tom Andersen, professor in psychiatry.

The university had opened in 1972. The medical school started in 1973, and I began studying in 1974. I would not say that Tom was like a father to us—that sounds too patronizing. Let me say that he was like a charming, unpredictable uncle or older brother. In the beginning he was a bit frightening—I did not always understand why he laughed, and probably I did not always understand what he meant either. But as we got to know him through interaction groups, lectures, seeing him with patients and families, and going through the course in muscle tension and respiration where the legendary physiotherapist Aadel Bülow-Hansen appeared, I understood that this was a rare, vivid, broadminded, and serious man. His respectful and open way of listening (and talking) to all kinds of people was an eye-opener. The way he intervened in families with conflicts and problems could, at first glance, seem mysterious, but it was never condescending. He taught by doing, not by telling us what to do. His respectful attitude is what I remember most, and I hope this has left its stamp on my way of communicating with patients and their families as well.

 

18. Movements of life

ePub

Berit Ianssen

In the late days of Christmas in 1990, Tom Andersen wrote a letter to me. He had read my written exam in Norwegian psy-chomotor physiotherapy. He liked the way I had written about the treatment of a patient—first describing what we did and what happened, and then afterwards trying to understand.

He wrote, “what about writing a book in this way—first describe what we did and what happened—and then try to understand?” And so we did. I invited different physiotherapists to participate, and Gudrun Øvreberg and four of my colleagues agreed.

We lived far apart, over the whole of Norway. The distance between us was like that of Oslo to Rome. We worked in private practice. So how to manage a book together—woven into our daily life?

We met in Harstad, in the north of Norway, several times. The first occasion was in September 1994. Here we talked about each others’ writing. We had a tape recorder on the table and changed tapes when we changed subject from the work of one to another. Then we brought home our tape—and the others’ voices on the tape—to help us when we sat working, sometimes late at night, on our own chapter in the book.

 

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