Development and application of systemic family therapy – an assessment of the situation in the expiring second decade of the 21st century and the challenge of a gender-sensitive new orientation

Размещено на http://www.allbest.ru/

Размещено на http://www.allbest.ru/

Webster university

Development and application of systemic family therapy - an assessment of the situation in the expiring second decade of the 21st century and the challenge of a gender-sensitive new orientation

Velasquezmontiel Sandra

Vienna

Historical development - an overview. It is always helpfUl to take a closer look at the development in order to understand the situation. Therefore, we would like to give a short outline of the development of the systemic therapy, which resulted from the general system theory, at this point, whereby no claim to completeness exists. The general systems theory is based on different scientific methods that initially emerged independently.

The considerations of the biologist Ludwig von Bertalanffy can be mentioned as general basics, as well as the concept of cybernetics developed by Norbert Wiener and W. Ross Ashby. These approaches were further developed by the action-theoretical system theory according to Parsons and the introduction of the term «organization» by Luhmann. The aim of general systems theory is to enable more accurate predictions of system behaviour.

As a practitioner, I have been trained in the last third of the development of systemic approaches. My point of view is therefore predominantly related to this stage of development of the systemic approaches as well as a regional one (Austria) as I am allowing myself to include my own experience and literature research in the affirmations to follow.

Among my first systemic books were the early works of Paul Watzlawick. Watzlawick was born in 1921 in Villach and was Austrian. After his Abitur (High School) and military service he moved to Venice, where he studied psychology and languages. Between 1951 and 1954 he was trained as a psychotherapist at the А.G. Jung Institute in Zurich. He admits, however, that he seldom succeeded in helping people. His turn to radical constructivism led him away from coming to terms with his formal psychotherapy training and to search for short, quickly effective forms of therapy. In 1957 Watzlawick became professor in San Salvador, and in 1961 he moved to California to the legendary Mental Research Institute in Palo Alto together with Don Jackson and other great thinkers.

As a systemic trained psychologist, I was impressed by Watzlawick's axiomatization of communication. The presentation of communication based on a comparison with scientific approaches gave me a first, fundamental insight into the deeper function of communication for therapeutic purposes. This approach to the laws of human communication has remained with me over the years in my clinical and counselling work. These fundamental approaches are still valid today and are indispensable not only in the systemic context. These principles serve as anchors should I get lost in the communication with my clients.

Watzlawick had built up his approaches mainly on the basis of classical communication systems. Everyone wants to be heard and seen. The increasing digitalisation of communication certainly reduces the analogue parts (voice pitch, body language etc.) and changes the communication mechanisms. In addition, there is an increase in online therapies. These developments should be reflected in the coming years and taken into account in therapeutic work. Good to underline that the analogue parts of the forms of communication have been highlighted by Erikson's approaches using hypnotherapy.

The years 1940-1979: An outline. Historically, one could think the beginning of the idea of systemic approaches into the year 1877. That year, Lasegue and Falret began their publications with the «folie a deux». Sigmund Freud also recognized that sometimes the family system and not the individual person is disturbed.

Karl Ludwig von Bertalanffy (then professor in Vienna and Canada) published in 1940 his work «Der Organismus als physikalisches System betrachtet». Another important work was published by him in 1949 («Zu einer allgemeinen Systemlehre», Biologia Generalis, 195:114-129).

Bertalanffy tried to develop a «general systems theory». His attempt was to find and formalize superordinate laws (physical, biological, social). The laws of action which can be found in systems are applied by him to other systems. In these, the terms complexity, equilibrium, feedback and self-organisation were cited by him.

In the following years, further approaches developed, especially in the USA, from interdisciplinary meetings of various branches of science. Norbert Wiener, Walter Pitts, Gregory Bateson, Murray Bowen, Don Jackson, Paul Watzlawick, Jay Haley, Heinz von Fцrster and John Weakland are the most prominent of these.

In 1948, for example, Norbert Wiener re-created the term «cybernetics», which was coined first by Plato (Novikov, 2016, p. 22), contains the theory of regulating the control of communication. During the development Wiener used terms from the field of physics and transferred them to communication. At the same time Warren Beatson, McCulloch, Gordon Pask, Ross Ashby, Heinz von Foerster, Norbert Wiener, Walther Pitts and others began to work on cybernetic models.

The Austrian Heinz von Fцrster joined this group in the early fifties. Heinz von Fцrster was an Austrian physicist who, in his first work, dealt with the quantum mechanical function of memory processes in the brain (Das Gedдchtnis…, 1948). Since the book publisher was not a physicist, he first sent the work for examination to the Austrian Nobel Prize winner in physics Erwin Schrцdinger. He found no error (Heinz von Fцrster was relieved), but did not believe in the solidity of the conclusions (what did not bother to von Fцrster).

However, this work in particular aroused the interest in America what led to an invitation to lecture in the subjest. Heinz von Fцrster subsequently became one of the leading theoretical system thinker and constructivists of his time.

Gregory Bateson, Don Jackson, Jay Haley & John Weakland first formulated the term «double bind» in 1956 (Toward a theory., 1956).

In 1959, Don D. Jackson founded the Mental Research Institute (MRI) in Palo Alto, California in cooperation with Virginia Satir, Paul Watzlawick and John Weakland.

In 1963, Jay Haley (Strategies of Psychotherapy) develops the approach of Strategic Family Therapy and Virginia Satir publishes her work Conjoint Family Therapy Science and Behavior Books.

Shortly afterwards, in 1965, Nathan founded the Family Institute Ackerman (Ackerman Institute) and Salvador Minuchin became director of the Philadelphia Child Guidance Clinic.

Cybernetics in family therapy is prominently treated with Gregory Bateson (Bateson, 2000). Contemporaneusly, Austrian Paul Watzlawick et al. published the work Pragmatics of Human Communication and as single author he whote his fundamental work «Human Communication». In this writings, Watzlawick refers to mathematical rules as the starting point for his considerations. German translations of these works are still largely lacking. The year 1969 also saw the birth of family sculpture, translating communication into postures in her family work.

At the beginning of the 70s of the last century, further European participations in the development of systemic therapy emerged. Mara Selvini Palazzoli published her work Self-Starvation in 1974. She based her therapeutic a therapeutic model on Gregory Bateson's cybernetics theory.

These years also saw the development of Structural Family Therapy (Salvador Minuchin: Families and Family Therapy) and Ernst von Glasersfeld worked on Radical Constructivism (Ernst von Glasersfeld: Piaget and the Radical Constructivist Epistemology) (Smock, Glasersfeld, 1974).

In 1975 the German Helm Stierlin published his book «Von der Psychoanalyse zur Familientherapie» and in 1976 the magazine Familiendynamik was founded. In 1977 the Milan model was created by Mara Selvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin and Giuliana Prata: Paradoxon und Gegenparadoxon and in 1978 the German Association for Family Therapy (DAF) was founded. It was not until 1979 that the first major family therapy congress in Europe was held in Zurich with the title «Family and Family Therapy».

Outline of the years 1980-2000. The year 1981 saw the development of contextual therapy with Ivan Boszormenyi-Nagy (Kontextuelle Therapie) as well as Maturana broadly exposed for the first time at a congress in Zurich. This event marks the birth of the newer systemic therapy as a further development of family therapy. 1983 Jьrgens Hargens founds the journal for systemic therapy, the journal Familiendynamik. This is subtitled «Interdisziplinдre Zeitschrift fьr System-orientierte Forschung» (Interdisciplinary Journal for Systemic Research).

In 1984 the German Niklas Luhmann published his work «Soziale Systeme. Grundriss einer allgemeinen Theorie» (Book: Social systems: Foundations of a general Theory) and Fritz B. Simon and Helm Stierlin published their book «Die Sprache der Familientherapie» (The language of Family Therapy). Although Niklas Luhmann remained a leading German-speaking representative of sociological systems theory and sociocybernetics in the years that followed, his works are purely theoretical in the sense that they have not gained any significance for therapeutic practice to this day.

In 1985 and 1986 Steve de Shazer («Keys to Solution in Brief Therapy») founded his solution-oriented short therapy while social constructionism became known through Kenneth J. Gergen (Book «The social constructionist movement in modern psychology» first published in 1986) Other authors as Harold A. Goolishian together with Harlene Anderson pioneer the principles of the narrative approach, which was further developed by White and Epston later in the nineties.

Focusing in the regional development of the Systemic Tharapy in Central Europe, The Austrian Association for Systemic Therapy and Systemic Studies (ЦAS) was founded in 1986 by Ludwig Reiter as a merger of three institutes for systemic family therapy: the Institute for Family Counselling and Psychotherapy, Graz, the Family and Counselling Association, Vienna, and the Systemic Initiative, Salzburg.

Originally, the ЦAS was intended as a discussion forum and first initiative for systemic studies with the aim of organizing workshops and congresses as well as to publish the journal «Systeme». In the end, however, the three training institutes merged into the ЦAS.

In 1987 the umbrella association for family therapy and systemic work (DFS) was founded and the journal «Systhema» was founded. In 1988 Ludwig Reiter, Ewald-Johannes Brunner & Stella Reiter - Theil (Ed.) published «Von der Familientherapie zur Systemischen Perspektive» (From family therapy to systemic perspective) which with time became a classical book for practitioners that includes the thinking of Goolishian, De Shazer, Stierlin and Welter-Enderlin.

During these years, the general term cybernetics of the 2nd order became popular (Lynn Hoffman: Jenseits von Macht und Kontrolle; «On the way to a systemic family therapy «second order» to be found in the «Zeitschrift fьr Systemische Therapie») by that time the concept of the Reflecting Team was introduced by Tom Andersen.

In 1990 influences from Australia began to gain a foothold in Austria and Germany with the narrative approaches of Michael White & Brian Epston (Narrative Means to Therapeutic Ends) and in 1992 a first writing on Systemic Therapy was published by Kurt Ludewig (Systemische Therapie. Basics of clinical theory and practice. Published in Stuttgart by Klett-Cotta). The concept of postmodernism by Jochen Schweitzer et al. also finds its way into the German language (Book: «Systemic practice and postmodernism»).

In December 1993, the ЦAS was recognized by the Austrian Federal Ministry as an afficial training institution for systemic therapy. Since 2002, the journal «Systeme» has been published jointly with the «Systemische Gesellschaft in Berlin». Today, the association offers curricula in Graz, Innsbruck, Salzburg and Vienna and is the largest specialist institution in Austria in terms of the number of graduates in the systemic therapeutic work

According to Ludwig Reiter, other Austrian members in particular were able to distinguish themselves nationwide: Joachim Hinsch took over (as Reiter's successor) the management of the renowned Vienna Institute for Marriage and Family Therapy. Andrea Brandl-Nebehay, for example, became famous with her book «Systemic Family Therapy».

In 1996, Arist von Schlippe & Jochen Schweitzer published her first textbook on systemic therapy and counseling, which was published especially for political reasons in order to be recognized as a form of therapy in Germany. Kurt Ludewig criticized the adoption of the ICD 10 into the systemic body of thought.

Outline of the years 2000-2018. Due to the historical background with Sigmund Freud, the recognition of therapeutic approaches as a method is traditionally faster in Austria than in Germany. If the Systemic Approach had already been recognised in Austria in 1993, this still remains to be done in Germany since this approach is not considered by the health insurance system for treatment refund.

In the course of this recognition discussion, Jochen Schweitzer & Arist von Schlippe, Kirsten von Sydow, Stefan Beher, Rьdiger Retzlaff, Jochen Schweitzer have intensively published a miriad of books and articles to emphasize the effectiveness of systemic therapy as well as to underline its evidence-based solidity.

In 2008 the Scientific Advisory Board for Psychotherapy in Germany classified systemic therapy for adult psychotherapy and child and adolescent psychotherapy as scientifically recognised and the first part-time Master's programme in clinical family psychology was launched. In 2009, the training to become a certified psychotherapist in systemic psychotherapy for adults began in Germany, which was recognised by the Ministry of Labour, Social Affairs, Health, Family and Women of Rhineland-Palatinate in December 2009. In 2011, the trainingto become a certified psychotherapist in systemic psychotherapy for children and adolescents was approved by the Landesprьfungsamt NRW in November. However, and as already mentioned, there is still no possibility of billing via health insurance companies. Another reason for this may be the trench warfare with psychoanalytic and behavioural therapy schools, which have a monopoly position in Germany.

In Austria, since 2018, a subsidy of 28 € per psychotherapy hour is paid by the health insurance. A referrals by a specialist doctor or a specialised institution is compulsory. This gesture underlined again the importance of psychotherapy (and the openness to recognize a variety of approaches) for the mental health of the population.

The solution-focused approach was traditionally strongly represented in the Austrian ЦAS until after the turn of the millennium. In the meantime, the first programmes of psychotherapy for infants have developed. Nevertheless, the effectiveness of these approaches has so far been more than controversial and hardly represented.

Especially in the years after 2000, the narrative approaches of Michael White and David Epston dominated many educational institutions in Austria.

Today, systemic schools in Austria are increasingly seeking cooperation with universities in some areas, which were rejected by training institutes in the 1990s. In Austria, however, subject-specific training remains in the hands of private training associations. This may be motivated primarily by monetary and monopolistic reasons.

It has been noted by the other schools of psychotherapy thatsystemic approaches have proven to be increasingly restrictive in particular for subconscious aspects and the use of diagnostic labels. The tendency to move towards an integrative position has seen hypnotherapy joining forces with systemic approaches in the hypno - systemic approach. This curricula underline the use of language during the counseling/ psychotherapeutic process without necessarily using an «official» trance induction during the session.

In particular, the hypnotherapeutic approach according to Erikson or clinical hypnosis should be mentioned. In contrast to systemic therapy, these approaches are predominantly taught by private entrepreneurs in Austria. On the basis of Milton Erickson, the founder of modern hypnotherapy, and Gunther Schmidt, the founder of hypnosystemic concepts, various further training courses are offered.

Currently, there is only one classical training association in Vienna (MEGA - Milton Erickson Gesellschaft Austria) in addition to the mainly private companies. This is a non-profit association for the promotion and distribution of clinical hypnosis according to Milton Erickson and offers further education. It must be seen as problematic that especially the hypnotherapeutic entrepreneurs in Austria do not recognize each other until now. An umbrella organisation is in the process of being established, but recognition of all those involved is not planned.

According to Milton H. Erickson, the main therapeutic goals in hypnotherapy are changes in physiological processes (e.g. muscle relaxation, lowering heart rate, blood pressure, slowing breathing), changes in dysfunctional cognitions, resource activation, processing negative experiences and developing coping strategies. In the meantime, this therapy method is widely used in therapeutic practice. Its effectiveness has been proven by various empirical studies and several meta-analyses. Especially the combination of hypnotherapy and systemic therapy is preferred by many authors. Research has indeed shown greater efficacy in a combination of approaches fusioned in combined interventions (Scarpinato-Hirt, Bauer, Ludecke, Riebensahm, 2013).

Outlook for 2018+ (Tempora mutantur, nos et mutamur in illis). Projections must always be made with caution. I would therefore like to confine myself to a few sentences, as I mention current developments.

Particularly in recent years, systemic approaches have been integrated into many psychotherapy courses. Purely classical orthodox training curricula in psychotherapy and counseling without systemic approaches, is hardly represented in Austria any more. The modern ideas of systemic therapy have found their way into many fields of work. As mentioned above, however, systemic approaches are also increasingly incorporating new ideas into their working strategies.

If hypnosystemic approaches have proved to be particularly helpful in the last 5-10 years, it is to be expected that they will be increasingly adopted from neuro-cognitive approaches in the coming years (mindfulness, mindfulness, brain-spotting, etc.). It remains to be seen to what extent systemic psychotherapy will continue to mix with other approaches in the future.

On systemic family therapy. As shown above, a large number of approaches and models have developed out of couple and family therapy. In Austria, the term systemic family therapy was the concept initially used.

In the meantime, the term systemic therapy or couple and family therapy is increasingly used. This is because the systemic approaches have also developed into single and couple psychotherapies. Family therapy also includes multi-generational approaches, transcultural family issues, separation and divorce problems, violence issues and other fields of work. Last but not least, family work in the case of mental illness should also be mentioned. The overriding goal of systemic family therapy is to find solutions together with clients, to design them and to accompany them.

In practice, one looks for boundary conditions with which one can activate resources in order to reach goals through selforganisation. Systemic therapists start from the autonomy of the clients and regard them as «experts of themselves». The central method is dialogue. The client is shown respect, impartiality, interest and appreciation for previous approaches. Today, systemic psychotherapists could be described depending on the method, as architects of reality, providers of new perspectives, co-constructors of new stories, dramaturges or similar.

The taught methods of systemic psychotherapy are extensive. Question techniques, self-reflexive dialogue, reflecting teams, visualization techniques, constellations, homework, final interventions, rituals, metaphors, etc. are widely used.

In the 90s the approaches of Michael White and David Epston caused a sensation. The point is to look at the meanings of stories. These attributions of meaning are essential to how clients interpret and perceive past, present and future experiences of their lives. This gives the life stories an interpretive power. Through a new interpretation, new biographies and meanings can be generated. The client thus becomes his own author and director of his life. He is reempowered to determine his life and actions.

The next frontier: Gender Equity in the counselling room. After decades of research in the field of gender, women's rights, feminism, there is an implicit tendency to put men's issues under the light of dominance, violence and a position of advantage against women's issues (Wright, 2017). This tendency distracts from issues that are necessary to be acknowledged and considered if we are to help men to overcome the challenges of the 21st century.

A quick review of project around the world where gender issues are addressed, it's the consideration of women's and girl's rights what is often underlined as gender equity. There are though more and more voices demanding the integration of men's needs and issues in projects, health and design of psychosocial projects (Farell, 2001).

The so called disposability and availability of men in society points to the weakness in society to recognize that also men suffer under the values governing specially in the labour system (being under pressure to be successful, to define identity through work, being cut from the family life) (Bohnisch, 2018).

Wright (2017) criticizes that counseling and psychotherapy pursue «feminine» goals as emotional disclosure. Paglia (Paglia, 2017) goes further accusing the new feminism to ignore the natural biological differences between men and women just to create the illusion of dwindling boundaries between genders. There seems to be a confusion between having the same rights and opportunities and recognizing differences between men and women as a threat of falling into gender inequity. The same thing seems to happen in the counseling field.

A grim warning of this inequity was the tragic fate of David Reimer, who was the victim of Dr. John Money (Colapinto, 2006) The attempt to present sexual identity as a mere construction led to ignore the other side of the coin: Nature and Genetics.

The field of psychotherapy, social work and counselling could profit from a model of gender deconstruction that recognizes the needs of men and women respecting their differences as well as enhancing equity of access to health, self actualization, self esteem among other variables of mental health.

As the reader has noticed, I started with a general description of the development of the systemic approach. I ended the last section mentioning the narrative work of White and Epston. There's the implicit thought, that psychotherapy and counselling do not need a separate training if the therapist or counselor is to treat men or women. There are increasing voices that men or more precisely, masculinity are ignored in their specific needs and multiple identities. Therefore, further research is needed in order to meet the mental health requirements from the perspective of increasing complexity of the multiple gender identities in the 21st century.

References

1. Novikov, D. (2016). Cybernetics: From Past to Future. Springer Verlag.

2. Das Gedдchtnis: Eine quantenphysikalische Untersuchung. Franz Deuticke Verlag, Wien, 1948.

3. Toward a theory of schizophrenia; Behavioral Science (1956), 1, (4), 251264.

4. Bateson, G. (2000) [1972]. Steps to an Ecology of Mind: Collected Essays in Anthropology, Psychiatry, Evolution, and Epistemology. Chicago, Illinois: University of Chicago Press.

5. Smock, C.D.& Glasersfeld, E. von (Eds.) (1974), Epistemology and education. Athens, GA: Follow Through Publications, 1-24. Scarpinato-Hirt, F., Bauer, A., Lьdecke C., Riebensahm, H. (2013). Hypnose - ZHH, 8 (1+2), 119-129.

6. Wright, P. (2017). Red pill psychology. Psychology for men in a gynocentric world. Independent Published.

7. Farell, W. (2001). The myth of Male Power. Why men are the disposable sex. Berkley Pub Group.

8. Bцhnisch, L. (2018). Der modularisierte Mann. Eine Sozialtheorie der Mдnnlicheit. Transkript. Gender Studies.

9. Paglia, C. (2017). Free Women, Free men. Pantheon.

Размещено на Allbest.ru