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CHAPTER TWELVE: Intersecting Levinas and Bion: the ethical container in psychoanalysis and family therapy

Flaskas, Carmel; Pocock, David Karnac Books ePub

Glenn Larner

In a previous publication, I defined a common ground between I psychoanalysis and family therapy as constructing a narrative or dialogical space to explore personal and relational meaning in the therapeutic relationship (Larner, 2000). Whereas the focus for family therapy is the systemic pattern of relationships, including the therapist-family interface, in psychoanalysis it is the emotional intensity of the transference relationship over the long term (Bertrando, 2002). I suggested that analyst and family therapist both integrate not-knowing and knowing in a both/and or deconstruc-tive stance of knowing not to know. Following Bion, this creates a narrative container, or reflective space, for thinking to emerge in the therapeutic conversation (Flaskas, 2002).

In this chapter, I intersect Bion's thinking with the ethical philosophy of Emmanuel Levinas in the idea of the “ethical container”. For Bion, containment is a relational process: a being with the patient in thoughtful reverie where emotional and symbolic meaning is held, interpretations are ventured, and thinking develops. For Levinas, the foundation of thinking is the ethical relation to the other. The “ethical” is the incomprehensible, the disruption of knowing by not-knowing in face-to-face encounter with the other (Larner, 2004). This intersection proposes that therapy is, first and foremost, an ethical relation where the therapist's stance of knowing not to know constructs an ethical container for thinking and for relational meaning to grow.

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CHAPTER NINE: Reflecting processes and reflective functioning: shared concerns and challenges in systemic and psychoanalytic therapeutic practice

Flaskas, Carmel; Pocock, David Karnac Books ePub

Mary Donovan

Historically systemic psychotherapy evolved in contexts of making sense of the difficulties of families and individuals H not readily amenable to a classical psychoanalytic, insight-orientated approach. They sought relief for their suffering, but did not necessarily view the interpretation of intrapsychic conflict as part of this focus. Over the years, systemic family therapy has constructed an impressive repertoire of alternative styles of practice for engaging and helping people to develop their capacity to stand back and reflect on their presenting difficulties as part of the change process. Circular and reflexive questioning, as well as reflecting teams, are notable examples of this rich legacy (e.g., Andersen, 1990; Brown, 1997; Tomm, 1987a,b).

Contemporary psychoanalysis demonstrates a similar preoccupation with exploring ways of engaging and working with people not readily responsive to a traditional interpretive approach. “We no longer practice in an era in which interpretation is viewed as the exclusive therapeutic arrow in the analyst's quiver” (Gabbard & Weston, 2003, p. 823). In psychoanalytic discourse, Fonagy and Target's theory of mentalization or reflective functioning (e.g., Fonagy & Target, 1996, 2003; Fonagy, Moran, Edgcumbe, Kennedy, & Target,1993; Fonagy, Steele, Moran, Steele, & Higgitt, 1991) is a notable example of this project to broaden the repertoire of psychoanalytic practice. This chapter explores shared ground between systemic and psychoanalytic orientations that this highlights, and specifically teases out connections between the systemic perspective on reflex-ivity and reflecting processes and the psychoanalytic perspective on reflective functioning. It concludes that the truly innovative nature of integrative thinking across the different therapeutic orientations is most clearly demonstrated in the endeavour to increase the range of those engaged and helped by psychotherapy.

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CHAPTER ELEVEN: What does the other want?

Flaskas, Carmel; Pocock, David Karnac Books ePub

Stephen Frosh

“O let them be left, wildness and wet;
Long live the weeds and the wilderness yet”

(Gerard Manley Hopkins, 1970, “Inversnaid”)

After a rocky start, which resulted in accusations (particularly from feminists) of normative politics and blindness to social inequality, systems theory has developed an honourable and now long tradition of engaging with oppression—gender, sexual, race, and class—and advocating democratic and emancipatory practices within therapy (e.g., Burck & Daniel, 1995; Mason & Sawyerr, 2002; McGoldrick, 1998). The shift from first order to second order cybernetics was crucial here, as it forced systemic therapists to consider their practices in a reflexive mode, a move that has resonance with the “relational “ move in psychoanalysis that has also struck a chord amongst feminists (Benjamin, 1998). Given the very large number of women working psychotherapeutically with children and families, it was perhaps predictable as well as necessary that systems therapy would have to deal with feminist concerns. Yet, subsequent extensions of the political critique toengage with “race “ and culture have provoked a very extensive and impressive attempt to come to terms with what is experienced as an even more challenging block in the therapeutic way of thinking. That is, female systemic therapists spoke from within their immediate experience when confronting sexism, and with the intellectual and political backing of a very powerful movement. In addressing issues of racialized oppression and conflict, family systems theorists and therapists—overwhelmingly white and western—have had to think through what it might mean to be confronted with “otherness”, including how they are incorporated into it and also how they might face the limits of understanding and of the appropriateness of their methods. In this context, the efforts of several senior and influential members of the systemic community to address cultural and “race “ concerns have been exemplary (Mason & Sawyerr, 2002; McGoldrick, Giordano, & Pearce, 1996), and some powerful attempts have been made to institute actively anti-racist procedures in family work (for example, by the “Just Therapy” group [Waldegrave, Tamasese, Tuhaka, & Campbell, 2003]).

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CHAPTER FIVE: Anger and boredom: unpleasant emotions in systemic therapy

Flaskas, Carmel; Pocock, David Karnac Books ePub

Paolo Bertrando and Teresa Arcelloni

Systemic therapy lacks a proper theory of emotion. In the early S days of systemic family therapy, the therapist focused on family interactional patterns, avoiding what the psychoanalytic paradigm had arbitrarily located in a non-observable area—the intrapsychic dimension—where emotions were thought to originate (Bertrando & Toffanetti, 2000). Afterwards, rationalism prevailed within strategic therapies. This saw human interactions as rational contracts between actors who actively sought what they considered the best for themselves (see Haley, 1976; Jackson, 1965). (Kleckner, Frank, Bland, Amendt and duRee Bryant [1992] contend that strategic therapists do not “ignore, avoid or neglect client feelings in treatment” (p. 41), and that such a “myth” is disproved by what strategic therapists actually do in sessions.) When emotions were reconsidered, they were defined as “predispositions for actions” (Maturana, 1988, p. 49) recalling, once again, their pragmatic and developmental function inside a system. Only in later years have emotions begun to find a place within social constructionist theorizing and systemic therapy (e.g., Fredman, 2004; Kavner & McNab, 2005; Pocock, 2005).Like most systemic thinkers, Maturana also emphasizes the positive functions of emotion. Little room is left for what we may define as unpleasant emotions, such as anxiety, anguish, anger, envy, ingratitude, boredom, indifference, disillusion, and disgust. There are many reasons for this. The first, though, is still traceable to the reaction to some key psychoanalytic ideas, from which systemic therapy felt a need to differentiate itself. Second is the optimistic and liberationist ideology intrinsic in the American psychotherapeutic tradition (on which most systemic family therapy was originally based): any individual is fundamentally good, and he or she is made bad only by external constrictions (Cushman, 1995). In this is rooted the tendency to see mostly resources and positive aspects in clients. This tendency was already present in Milton Erickson's work (the celebrated Ericksonian motto, that everyone always does her best, in the situation she is in; Lankton, Lankton, & Matthews, 1991), and brought to its maximum expression by narrative (White, 1995) and conversational (Anderson, 1997) therapists.

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CHAPTER SIX: Working with emotional systems: four new maps

Flaskas, Carmel; Pocock, David Karnac Books ePub

David Pocock

The worst dentist I ever had was a Scotsman with terrible breath who engaged in the sort of institutionalized lying T that was common, I suspect, in the dentistry of children in the early 1960s. The phrase “It will'na hurt laddie”, I soon came to realize, heralded the onset of unavoidable squirming agony …or so I remember it. And “Never mind laddie, just a wee bit more” was a sure sign that whatever he was doing to me would not be finished this side of lunch-time. My best strategy, apart from simultaneously tensing every part of my body, was to dig my nails into my palms to try to spread the pain around as much as possible.

The best dentist I ever had, about ten years ago, was a Home Counties woman who, whenever I flinched, said, “Ooh”, as if I were a baby, which, of course, in some ways, I am. Her “Ooh” was not a direct reflection of my feeling but an acknowledgment that it hurt, plus a small modification of that hurt. The modification was a little pantomime that showed, quite unconsciously, that while she recognized the pain, she was not feeling it as I was (it would be no good for us both to squeal) but it was a compassionate acknowledgment of my discomfort and her part in causing it. Sadly, she leftthe practice after five comparatively painless years, presumably to become a saint.

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