Multiple Voices: Narrative in Systemic Family Psychotherapy

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Part of the Tavistock Clinic Series, this book focuses on narrative and stories in Family Systems Therapy - particularly on how stories develop within the domain of a therapist's own theoretical, clinical and professional contexts. The aim is to allow the reader to understand the uses of stories in family therapy.This book offers a comprehensive overview of issues related to narrative which appear in a family therapy setting. Originally embarking on a joint project to share clinical experience, members of the Family Systems Group at the Tavistock Clinic discovered that what was common in their work was their emphasis on narrative. This discovery led in time to the development of a shared discourse about their diverse approaches to narrative which are carefully reflected in the contributions in this volume. Part One sets out the context of narrative with contributions on bilingualism and the family's experience of therapy, ending with a thought provoking critique of narrative. Part Two concentrates on applications of these ideas, providing analysis of multiple narratives in illness and loss, gender and language, neonatal care, adoption, divorce and refugee families.

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1. The Other Side of the Story: The Client's Experience of Therapy

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Listening for the Client’s Experience of Therapy

David Campbell

Introduction

I have been a family researcher all of my life. As the second and last child born into my family I arrived to discover (or should I say invent) a ready-made family of mother, father and older brother, and I suppose I have been trying to make sense of how to ‘fit in’ ever since.

In many families the youngest child slots into a favoured role, but in my case, I was more interested in growing up and joining the others. I soon became interested in power and inequality and the struggle to get more power for myself without revealing my wish to destroy all my competitors. As I look back now on my childhood preoccupation with sports and teams, I see it as an opportunity to gain power in ways that are reasonably acceptable. I have always supported the ‘underdog’ to win a sporting competition because I can deeply identify with the struggle to overcome the odds.

As a family therapist, my most significant journey has been the one from structural family therapy to the Milan approach. Following training events with Minuchin, Aponte and Walters in the 1970s, I could see how effective these therapists were with troubled families; but they were also people holding and utilising considerable power; and, although I tried to master these new techniques, I couldn’t help feeling this therapeutic style, unfortunately, just wasn’t me. With the arrival of the Milan approach in the early 1980s with its emphasis on neutrality and an open, circular style of questioning, I felt this style allowed me to become powerful in more subtle ways which I was used to. Perhaps it allowed me to be powerful without openly demonstrating the exercise of power. And in the meantime, I feel I have now been able to develop a style which integrates different models and techniques because I am more interested, and more comfortable, exploring expressions of power and powerlessness in myself as well as the family as a basis of much of my work with families.

 

2. What Narrative?

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Sebastian Kraemer

Therapists like talking about therapy, about their own kind and about other kinds. Whatever the task, human groups have to reinforce their identity by defining their own special ideas and skills and contrasting them with those of other groups. This tribal process is necessary in any enterprise which demands courage and skill and where there are in the end no right answers. Psychoanalysis and systems are the two tribes I know most about and the differences between them are compulsively interesting to those involved. But there are similarities too. The overriding effort to make sense of psychological or behavioural problems through observation and understanding is common to both practices, even if the techniques are different. Furthermore, there is inevitably a story to be unravelled in either of these kinds of therapy. The original work of psychoanalysis was to discover the nature of past events that had so disturbed the patient that she forgot them and developed psychological symptoms instead.1 The debt owed to psychoanalysis by all subsequent psychotherapies is immense, but rarely acknowledged.

 

3. Language and Narrative: Learning from Bilingualism

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Learning from Bilingualism

Charlotte Burck

Learn a new language and get a new soul Czech proverb

Narrative

As narrative has become a significant metaphor in the systemic therapy field, attention has focused on how people construct and live their identities. The central tenet of narrative theory is that the self is constructed - is storied through interaction with others, and that in this process language produces meaning and does not just reflect experience. A vivid illustration of an extreme form of this construction of self is provided by Oliver Sacks in his description of one of his patients who had lost his memory. This man confabulated frenziedly, continually creating a world and ‘self’ from the evidence before him, to replace what was constantly being forgotten and lost - he ‘literally ma[d]e himself (and his world) up every moment’ (1985, p. 105). Most of us, in ordinary circumstances, find ways to keep at least some threads of continuity running through our accounts, and to maintain a sense that we are the same person throughout.

 

4. Postmodern Narratives: or Muddles in the Mind

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or Muddles in the Mind Stephen Frosh

Reading the Reality of Postmodern Texts (or, ‘Reading’ the ‘Reality’ of ‘Postmodern’ ‘Texts’)

You are about to begin reading Stephen Frosh’s latest article, Postmodern Narratives, or Muddles in the Mind. Relax. Concentrate. Dispel every other thought. Let the world around you fade. Best to close the door; the TV is always on in the next room. Tell the others right away, ‘No, I don’t want to watch TV!’ Raise your voice - they won’t hear you otherwise - ‘I’m reading! I don’t want to be disturbed!’ Maybe they haven’t heard you, with all that racket; speak louder, yell: ‘I’m beginning to read Stephen Frosh’s new article!’ Or if you prefer, don’t say anything; just hope they’ll leave you alone.

This is, of course, a parody of the opening of Italo Calvino’s (1981) novel, // On a Winter’s Night a Traveller. When I say, ‘of course’, of course, I am suggesting that this is a novel known to all. Because I am suggesting this, readers are likely to feel they should know it, so I can claim it as an authoritative voice, something with credentials and credibility. My ‘of course’ is equivalent to a statement that this is an important and well-known text, to be taken seriously as a cultural expression, and hence useable as a reference. ‘Of course’ my opening is a parody of the opening oilfOn a Winter’s Night a Traveller, how could anyone not know that? By the way, when I use the term ‘parody’, I mean it is an almost exact copy. I suppose, however, that given that this article is about postmodernism, I ought really to say that I have written a pastiche. In Jameson’s (1984) terms:

 

5. Toward a Coherent Story about Illness and Loss

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John Byng-Hall

My Personal Story

I was brought up on an isolated farm in the Rift Valley in Kenya. My nuclear family was very close, yet very distant from everyone else. I was suddenly thrust into the distance myself at the age of seven by being sent to boarding school. When I was older I could begin to tell a coherent story about that experience. It was not that my family wanted to get rid of me, but because schools were a day’s drive away and it was either boarding school or no school. Some of my worst memories were of being sick at school.

When I left home at the age of 18 to go to University in England I became sick on the liner while it was passing through the Suez Canal. It was not until the ship was in mid Mediterranean that polio was diagnosed. I was paralysed from the waist down. Feeling awful and frightened, I can vividly remember one of the nurses looking very scared of me and running to the door. From then on she monitored my breathing by watching from the door. Would it spread upwards to affect my breathing? I was taken off the boat at Brindisi in Southern Italy. No one spoke English.

 

6. Different Language/Different Gender: Narratives of Inclusion and Exclusion

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Narratives of Inclusion and Exclusion

Barbara Dale and Jenny Altscbuler

Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.

Susan Sontag, 1991, p. 3

Introduction

This quote from Susan Sontag graphically introduces the politics of illness, the profound importance of staying healthy and not becoming a citizen of the other place. In this Susan Sontag stresses how it is impossible to take up a position in the kingdom of the ill unprejudiced by metaphors that include implications of shame and personal blame. The families that we have seen in therapy have shown us how costly it is for the ill to carry the responsibility of keeping the well safe. It is in the face of these pressures that ill and healthy parents have to find a way of renegotiating the meaning of parenting when they find themselves or their partners ill, in pain, incapacitated and facing the possibility of death. For this chapter we have drawn on clinical work with parents who are in heterosexual relationships where one member is seriously ill. We explore how illness can challenge the way in which men and women relate to one another, altering the stories of what can be known and understood.

 

7. Making Sense of the Experience of Neonatal Intensive Care

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Anne McFadyen

Introduction

Stories are told in order both to come to terms with and to shape experience, to pass on information, to re-edit, to share, to co-evolve, and to amuse and capture the imagination. They are tools in the task of meaning-making, serving both storyteller and listener or interpreter. As such, they lend themselves well to the task of research, the impact of which must be via a story of some kind.

In this chapter, I will describe a research project carried out while studying for an MSc in Family Therapy. My story about the project, which set out to examine developing mother-child relationships in a neonatal intensive care unit, will include an account of some of its many contexts, both personal and theoretical. I will consider the issue of ‘systemic’ research and, in keeping with the theme of this book, address the use of narrative as a research tool as well as presenting themes from the narratives of mothers of special care babies.

Contexts

The Personal Meets the Professional

 

8. New Stories for Old? The Creation of New Families by Adoption and Fostering

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The Creation of New Families by Adoption and Fostering

Caroline Lindsey

Introduction

The time when this story begins is in the mid to late nineteen-seventies, when I started to work as a consultant to an inner city social services department, based in an observation and assessment centre. It was an exciting time for child care as important discoveries were being made. Family therapy was finding application in work with families in breakdown, where there was a crisis of the reception of a child into care (Lindsey, 1985). The development of the Milan Systemic approach (Palazzoli et al., 1978) provided the means to conceptualise the complex multisystemic interrelationships involved in the social services context. Systemic hypothesising allowed the therapist to include the interfaces between the therapist, child, family, social work and legal systems in her thinking and to consider, at any one point, where the most effective intervention might be made. For example, it might address the social work team, to enable the resolution of a difference of professional views. It might be focused on the relationship between the social worker and foster carer. By resolving a difficulty about the management of a child in care, the child might be freed from the conflict, thus leading to a reduction in symptomatic behaviour. The stance of neutrality, latterly termed curiosity, (Cecchin, 1987) made it possible to sustain therapeutic endeavour in the face of the pervasive sense of defeat and hopelessness, which often enveloped those who were struggling with the issues of child protection.

 

9. Rewriting the Story: Children, Parents and Post-Divorce Narratives

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Children, Parents and Post-Divorce Narratives

Gill Gorell Barnes & Emilia Dowling

Each year during the early 1990’s about 160,000 families with children under sixteen went through an experience of their parents divorcing. Of the children one in three were under five years old and a further seven thousand between five and ten years old (Haskey, 1995). Research from many countries has shown how aspects of the divorce experience has both short and long term effects for many children and in this chapter we will focus on how the stories parents tell themselves about the divorce process, contextualises different kinds of childhood experience.

The chapter is based on our experience of having set up a clinical service for families living through processes of separation and divorce as well as subsequent family reconstruction. The service was set up for any child referred with psychological difficulties relating to a parental divorce. It was based on former clinical experience that at a time of family breakup there would be a number of different stories surrounding the lead up to the divorce and to the divorce event itself. The way a story is told offers a particular meaning given by each individual to his or her lived experience; in conflict ridden situations, stories made by each of the child’s parents are often not possible for the child to reconcile. We therefore organised the service so that each person’s differing views and the differing stories held within different subsystems in the family would be taken into account by offering individual interviews to each parent and to the children. We made it our goal to develop an ongoing overall post-divorce family narrative which would allow the acknowledgement that there are many different views of equal validity. Our hope was that children would no longer then be required to falsify their own experience in the service of each parents’ reality in order to maintain their parents ‘illusion’ of the truth. We paid particular attention to the child’s view, knowing from former work how it might be different from either of the parents, and how the child might be required to privilege other views above his or her own. When we felt we understood something of the different and competing realities, we saw as much of the family together as could be reconciled within one meeting to share the differences we had experienced.

 

10. Is Home where the Heart is? Narratives of Oppositional Discourses in Refugee Families

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Narratives of Oppositional Discourses in Refugee Families

Renos K. Papadopoulos and Judy Hildebrand

Introduction

As long as human beings have had homes, they have always been at risk of becoming refugees, uprooted by natural disasters, interpersonal and group conflicts, war and territorial competition. The refugee condition affects many facets of life from the most tangible external aspects such as shelter, food, health, education and often even physical survival itself, to a wide spectrum of psychological dimensions. These can range from subtle and often initially imperceptible experiences of a lack of safety, disruption, abandonment, displacement and disorientation, to more noticeable and obvious experiences of destruction, violence, loss and disorganisation. Similar to many other potentially painful events in the life cycle, such as the onset of illness, bereavement, leaving home, family relocation, and divorce, becoming a refugee engenders stressful experiences which may lead to temporary or permanent psychological dysfunction in individuals, families and communities. However, such experiences, despite their painful nature, may also have positive consequences in so far as they may lead to the development of more appropriate coping mechanisms, deepen a sense of identity in individuals, strengthen cohesion among family members, and offer an opportunity for a more fundamental re-evaluation of one’s life. It is not uncommon for members of refugee communities to become extremely successful in a wide variety of activities and careers in the receiving country and to lead creative and fulfilling lives (Knox, 1997).

 

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