Postmodern
Family Therapies
Innovations
introduced by postmodern therapies including nar-rative, solution-focused,
collaborative language systems and feminist family therapies (Andersen, 1987;
Anderson, 1997; de Shazer, 1985; Epston, 1989; Epston and White, 1992; Freedman
and Combs, 1995; Griffith and Griffith, 1994; Madsen, 1999; O’Hanlon and
Weiner-Davis, 1989; Penn, 2001; Tomm, 1987; Weiner-Davis, 1992; Weingarten,
1995; White, 1989, 1995, 2000) have opened new ways for families to solve
problems by valuing and learning from their own experiences, histories,
traditions, values and identities, instead of seeking answers from mental
health experts. The postmodern therapies have sought to em-power families by
helping them to develop reflective processes for exercising choice, to build
supportive communities with other families, and to clarify undesirable ways in
which cultural influ-ences have limited appreciation and utilization of the
family’s own practical wisdom. In these ways, the postmodern family therapies have
rendered family therapy more usable for those whose lives vary from the
stereotypic American two-parent, middle-class, nuclear families, traditionally
the largest consum-ers of private-practice family therapy.
The
postmodern therapies have made contributions that have broadly influenced the
clinical practice of family therapy through:
the art of crafting interview questions
for fostering reflection and creative problem-solving;
·
clinical methods that help patients and families to
identify and use skills, competencies, and resources from their everyday
lived-experiences;
·
clinical methods that counter adverse influences of
culture in generating and maintaining problems that families face.
Each
person makes sense out of his or her life experiences by attributing meaning to
them. This meaning is shaped by a canon of personal narratives as they are told
and retold to self and to others. Among the most important of these narratives
are those of identity about who one is as a person and as a family. There are
certain dominant narratives in a person’s life that, more than others, organize
one’s perceptions, cognitions and actions. How a family member views oneself
and the other family members is shaped by the limits of the language – the metaphors,
stories and beliefs – he or she employs.
Impasses
occur in family relationships, and problems emerge when
·
one or more family members lack either the needed
emotional vocabulary or the needed narrative skills to make one’s per-sonal
experience understandable to others;
·
the available narratives preclude ways of relating
other than conflictual ones;
·
specific words hold very different meanings for
different fam-ily members due to different personal narratives connected to the
language (e.g., “loyalty,” “trust,” “safety”);
·
family members have become positioned relationally
such that they cannot hear, tell and/or expand their stories in conversa-tion,
i.e., they have become confused by or habituated to the conflict such that they
have stopped listening
Therapy
provides a context where narratives that limit and constrain relationships can
be identified. The power ofconstraining narratives can be attenuated through
careful interviewing that renders visible the specific historical, cultural, or
political contexts from which they emerged and the hidden interpretive
assumptions upon which they rest. Alternatively, more useful narratives often
lie unnoticed within forgotten ex-periences the partners have had with one
another, but are now outside their recollection.
·
Listen for the exact words and precise manner in
which people use language. The focus of therapy is the language itself and the
limits of its possibilities, not what this language is inter-preted to mean.
·
Metaphors, phrases and prominent or repetitive
words in the family members’ specific uses of language are noted as “doors to
be knocked upon” by asking specific questions about stories of lived-experience
that have given them meaning.
·
“Unique outcomes” or “exceptions” when problems
might have been expected to occur, but did not.
Narrative
approach to therapy consists of two phases:
§
First Phases: A first priority is creation of a
therapeutic relationship within which important first-person narra-tives can be
safely told, heard and changed. In particular, the therapist carefully watches
for nonverbal signs that the dialogue is opening up or closing down, such as
family members’ breathing, posture, and flow and tone of speech. Creating a
relationship and a conversation favorable for the telling of important personal
stories is the priority, not gath-ering data.
§
Second Phase: As important first-person narratives
relevant to the problem are told, the therapist asks carefully designed
questions that facilitate:
i)
retrieval of other forgotten, or unnoticed,
narratives that might enhance solving the problem of the therapy, in con-trast
to the dominant narrative;
ii)
cocreation of an alternative narrative to a form
that holds more possibilities for resolving the problem of the therapy;
·
The therapist utilizes such questions as circular,
reflexive, unique outcome, or relative influence questions (Tomm, 1987; White,
1989).
·
A solution-focused therapist may assign
couple-partners the task of studying segments of time when the problem is “not”
occurring, looking for “exceptions…” Examples of solution-focused questions
include:
i)
“Between now
and the next time we meet, I would like you to observe – so that you can
describe to us next time – what happens between both of you that you do value,
would NOT want to change, and would like to see continue to happen in the
future”.
ii)
The Miracle Question (de Shazer, 1985): “Suppose
that one night, while you were asleep, there was a miracle and this problem was
solved. How would you know? What would be different? How would your partner
know without your even saying a word about it?” [The therapist then negotiates
with the partner(s) what part of this new reality the partner(s) would be willing to implement the
next day, as if the mira-cle had occurred.]
iii)
(Weiner-Davis, 1992) “If the problems between you
and your partner got resolved all of a sudden, what would you do with the time
and energy you have been spending on fixing or worrying about the marriage?
Describe what you would do instead”.
iv)
(Weiner-Davis, 1992) “What might be one or two
small things that you can do this week that will take you one step closer to
your goal?”
v)
(Weiner-Davis, 1992) “What, if anything, might
present a challenge to your taking these steps this week, and how will you meet
the challenge?”
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