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How to cite this thesis
Surname, Initial(s). (2012) Title of the thesis or dissertation. PhD. (Chemistry)/ M.Sc. (Physics)/ M.A. (Philosophy)/M.Com. (Finance) etc. [Unpublished]: University of Johannesburg. Retrieved from: https://ujdigispace.uj.ac.za (Accessed: Date). FAMILY THERAPY: Strategic and Ecosystemic Approaches
by
ROLENE HOVSHA
Dissertation submitted in partial fulfilment of the requirements for the degree
MASTER OF ARTS
in
CLINICAL PSYCHOLOGY
in the
FACULTY OF ARTS
at the
RAND AFRIKAANS UNIVERSITY
Supervisor: Dr M.F. Joubert
------__0 JUNE 1990 Family Therapy: Strategic and Ecosystemic Approaches
- Acknowledgements -
I wish to express my appreciation to-
My husband, Michael for his patience and constant support.
My supervisor, Dr Marietjie Joubert for agreeing to undertake supervision of this study in spite ofan already pressuredschedule. Her patientguidance, encourage ment and genuine interest is appreciated.
My colleague, Anne lunsky, for her valuable assistance in editing the script.
The Rand Afrikaans University and the Human Sciences Research Council for providing financial assistance which made these years of study possible. The opinions expressed in this study are those of the writer and in no way reflect the opinions of the Rand Afrikaans University or the Human Sciences Research Council.
-i- Family Therapy: Strategic and Ecosystemic Approaches
-Abstract-
As family therapy has gained acceptance as a treatment modality within the mental health field, increasing attention has been directed towards theory development. With the focus on theoretical issues, including that of epistemol ogy, a division has arisen between strategic and ecosysternic approaches to family therapy. Thisstudy was undertaken in order to examine the nature of thisdebate. The work of Jay Haley was chosen as representative of the strategic approach, and that of Bradford Keeney as representative of the ecosystemic approach to family therapy.
The study proceeded on the assumption that fundamental differences exist between the two approaches, which reflect the difference between a lineal and a non-lineal epistemology.
In order to place the study in context, the historical development of the family therapy field was reviewed and the conclusion was reached that family therapy represents a method of conceptualising human behaviour, which isdiscontinuous with previous conceptualisations, and which parallels similar shifts in other disciplines.
The concept of epistemology within the family therapy field was explored. The lack of claritywhich continues to characterise the use of this term within the field, may be attributed, at least in part, to its confusing use by influential writers in the field.
The underlying assumptions, central theoretical concepts and methodology of both Haley's strategic therapy and Keeney's cybernetic epistemology, were delineated and the two approaches were then compared along a number of critical dimensions.
The investigation established significant conceptual differences between the two approaches and the conclusion was reached that these differences reflect essen tial epistemological differences. While Keeney's ecosystemic approach is consis tent with a non-lineal epistemology, Haley's approach continues to reflect an underlying lineal epistemology.
, I ! I
1'1
-ii- Family Therapy: Strategic and Ecosystemic Approaches
- Opsomming-
500s wat gesinsterapie aanvaar word as behandelingsmodaliteit binne die gees tesgesondheidsveld, het die ontwikkeling van teorie meer en meer aandag begin geniet. Met die klem op teoretiese vraagstukke, insluitend die van epistomologie, het 'n skeiding onstaan tussen die strategiese en ekosistemiese benaderings tot gesinsterapie. Hierdie studie is onderneem juis om die aard van die skeiding te ondersoek. Die werk van Jay Haley is gekies as verteenwoordigend van die strategiese benadering terwyl die van Bradford Keeney gekies is as verteenwoor digend van die ekosistemiese benadering tot geginsterapie.
Datdaarwel basieseverskilletussen dietwee benaderings bestaan, watdieverskil tussen 'n liniere en nle-liniere epistomologie weerspieel, word gebruik as vertrek punt vir die studie.
Ten einde die studie binne konteks te plaas, word die geskiedkundige ontwik kelingvan die gesinsterapieveld onder die soeklig geplaas. Die outeur het tot die volgende gevoltrekkinggekom: Gesinsterapie is 'n metode van konseptualisering van menslike gedragwatverskil van vorige konseptualiseringspogings, en wat baie na is aan soortgelyke skuiwings binne ander dissiplines.
Die konsep van epistemologie soos gebruik in gesinsterapie word noukeurig ondersoek. Die gebrek aan duidelikheid wat die gebruik van hierdie term nog steeds binne hierdie studieveld karakteriseer, kan gedeelteliktoegeskryf word aan die verwarrende gebruik daarvan deur gesaghebbende skrywers in die veld.
Die onderliggende veronderstelling, sentrale teoretiese konsepte en metodologie van beide Haley se strategiese terapie en Keeney se kibernetiese epistemologie word gedefinieer waarna die twee benaderings met mekaar vergelyk is in terme van 'n aantal kritiese dimensies.
Die ondersoek het aansienlike konseptuele verskille tussen die twee benaderings aan die liggebring. Bogemelde ondersoek het gelei tot die gevolgtrekking dat die verskillewesenlike epistemologiese verskilleweerspieel. Terwyl Keeneyse ekosis temiese benadering met die nie-liniere epistemologie strook, weerspieel Haley se benadering nog steeds 'n onderliggende liniere epistemologie.
-iii- Family Therapy: Strategic and Ecosystemic Approaches
- Table of Contents -
page
Chapter 1 - Introduction
Chapter 2 -Historical Overview
2.1 Introduction 4
2.2 Change in Scientific Paradigms 4
2.2.1 Periods of "normality" 4
2.2.2 The emergence of Alternative Paradigms 4
2.3 Family Therapy As Paradigmatic Revolution 5
2.3.1 Psychoanalysis and the Medical Model 5/
2.3.2 Research as the Impetus for Family Therapy 5
2.4 The Emergence of Family Therapy within Context 6
2.4.1 The Newtonian World View 6
2.4.2 Psychotherapy within a Newtonian Paradigm 6
2.4.3 The New Science 7
2.4.4 Psychotherapy within an Alternative Paradigm 7
204.5.- General SystemsTheory 8
2.5 The Contribution of Gregory Bateson 8
2.5.1 Implications of the Double-Bind Research 8 eJ Expansion ofthe Family Therapy Paradigm 9 Early Researchers in Family Therapy 9
G22.7.1 lidz 9
2.7.2 Murray Bowen 10
2.7.3 lyman Wynne 11
2.8 The Contribution of Nathan Ackerman 12 Family Therapy: Strategic and Ecosysfemic Approaches
2.8.1 Social Role 12
2.8.2 Complementarity, Conflict and Prejudicial Scapegoating 13
2.8.3 View of Pathology 13
2.8.4 Goal and Process of Therapy 14
2.8.5 Roles of the Therapist 14
2.8.6 Methodology 14
2.8.7 Theoretical Inconsistency in Ackerman's Position 14 ~ The Development of the Family Therapy Field 15 , 2.9.1 The Decade of the 1950's 15
2.9.2 Family Therapy in the 60's and 70's 15
2.9.3 The Current Status of Family Therapy 16
2.9.4 The Issue of Epistemology and Family Therapy 16
Chapter 3 -Epistemology
3.1 Introduction 18
3.2 Defining "Epistemology" 18
3.2.1 Definition of the Term within the Family Therapy Field 18
3.2.2 Epistemology, Ontology and Metaphysics 19
3.2.3 "Epistemology" as distinct from "Theory" and "Paradigm" 19
3.3 Epistemology and Family Therapy 19
3.4 Bateson and Epistemology 20
3.4.1 Use of the Term "Epistemology" in Bateson's Work 20
3.4.2 Epistemological Errors 22
3.5 Keeney's View of Epistemology 22
3.5.1 Drawing Distinctions 22
3.5.2 Observation and Description 23 Family Therapy: Strategic and Ecosystemic Approaches
3.5.3 Punctuation 23
3.6 Critique of Keeney's Position 23
3.7 Conclusion 23
Chapter 4 --The Strategic Approach
4.1 Introduction 25
4.2 Definition 25
4.3 Influences on Haley's Work 26
4.3.1 Early Influences 26
4.3.2 The Work of Milton Erickson 26
4.4 The Double Bind Project 26
4.4.1 The Impetus for the Project 26
4.4.2 The Directive of the Project 27
4.4.3 The Investigation of Schizophrenic Communication 27
4.4.4 Conflict in levels of Message and Paradox as a Basis for Schizophrenia 27
4.4.5 The Concept of Family Homeostasis 28
4.4.6 Towards a Theory of Schizophrenia 28 ! 4;4.7 The Concept of the Double Bind 28
4.4.8 Applications of the Double Bind Theory of Communication 29
4.4.9 Direct Observation of Schizophrenic Families in Interaction 29
4.4.10 Critique of the Double Bind Theory 29
4.4.11 An Interpersonal Context for the Double Bind 30
4.4.12 Haley's Organizational Model of the Schizophrenic Family 30
4.4.13 Trance Induction and the Issue of Control 31 l Family Therapy: Strategic and Ecosysfemic Approaches
4.4.14 Summary: Implications of the Double Bind Project for Psychotherapy 31
4.5 Assumptions Informing Haley's Work 32
4.5.1 Introduction 32
4.5.2 Criteria for a Theory of Therapy 32
4.5.3 Ideas which Handicap Therapists 33
4.5.4 Power 34
4.5.5 Organization and Hierarchy 34
4.5.6 Sequencesof Behaviour 35
4.6 Theoretical Concepts 35
4.6.1 Introduction 35
4.6.2 Behaviour in an Interpersonal Context: Defining Relationships 35
4.6.3 Levels of Communication 36
4.6.4 Interpersonal Maneuvres and Control in Relationships 36
4.6.5 Types of Relationship 36
4.6.6 Digital and Analogic Communication 37
4.6.7 Nature of Qysfunction 37
4.6.8 Nature and Process of Therapy 40
4.6.9 The Nature of Change 42
4.7 Methodology 43
4.7.1 Introduction 43
4.7.2 Therapeutic Directives 43
4.7.3 Therapeutic Ordeals 44
4.8 Summary and Conclusions 44 Family Therapy: Strategic and Ecosystemic Approaches
Chapter 5 --The Ecosystemic Approach /
5.1 Introduction 45
5.2 Assumptions Informing Keeney's Wor~ 45
5.2.1 The Influence of Gregory Bateson 45
5.2.2 Constructivism 47
5.3 Keeney's Cybernetic Epistemology 48
5.3.1 Definition 49 5.3.2 Central Conceets -49 5.4 Cybernetics 52
5.4.1 Simple Cybernetics 52
5.5 Cybernetics of Cybernetics 53
5.5.1 Self-Reference 54
5.5.2 Autonomy 54
5.5.3 The Family as an Autonomous System 54
5.5.4 Dialectic of Calibration and Feedback 54
5.5.5 Mind as a Cybernetic System 55
5.5.6 Cybernetic Complementarities 55
5.6 Cybernetic Family Therapy 55
5.6.1 Introduction 55
5.6.2 The Therapeutic System 55
5.6.3 The Cybernetic View of Health and Pathology 56
5.6.4 the Nature of Change 57
5.6.5 The Process of Therapy 58
5.7 Summary and Conclusions 60 Family Therapy: Strategic and Ecosystemic Approaches
Chapter 6 --,Comparing Ecosystemic and Strategic Approaches
6.1 Introduction 61
6.2 Informing Epistemology 61
6.2.1 Assumptions Informing Haley's Work 62
6.2.2 Keeney's Cybernetic Epistemology 63
6.2.3 The Nature of Reality 63~
6.2.4 Health and Pathology 64\//
6.2.5 Science, Objectivity, Prediction and Self-reference 65
6.2.6 Cybernetics and the Cybernetics of Cybernetics 67
6.2.7 The "Powet" Debate 69
6.3 Methodology 75
6.3.1 Aesthetics and Pragmatics 75
6.3.2 Techniques of Intervention - Process or Content Focus 79
6.4 Summary and Conclusions 80
Chapter 7 -Summary and Conclusions
7.1 Introduction 81
7.2 Epistemology and the Family Therapy Field 81
7.3 The Strategic Therapy of Jay Haley 81
7.4 Keeney's Ecosystemic Epistemology 82
7.5 Comparing Strategic and Ecosystemic Approaches 82/
7.6 Conclusion 83
References --
- List of Tables --
Table 5.1 50
Table 5.2 60 Family Therapy: Strategic and Ecosystemic Approaches
--Chapter 1 Introduction
·Family therapy was, and stillis a wondrousTower ofBabel; people in it speakmany different tongues·(Hoffman, 1981, p.9). Family Therapy: Strategic and Ecosystemic Approaches
In recent years family therapy has emerged as a significant and popular treatment modality in a variety of clinical settings. While the history of the family therapy field is relativelybrief, itsdevelopment has been rapid and intense, with a proliferation of schools of thought, treatment methods as well as a burgeoning literature and a growing body of research. -
At present, as the quote from Hoffman's book suggests, the great variation that has emerged among family therapists, has led to a lack of theoretical clarity in the field. Workers in the field have rather tended to focus on clinical techniques. Consequently, family therapy has not been guided by a uniformly consistent paradigm (Searight & Openlander, 1987). As levant (1984) points out, at this stage in the development of the field of family therapy, while there are several well-delineated conceptual frameworks, the field still lacks a unified theory of the family. levant uses the following distinction between the terms "conceptual framework" and "theory". Based on Hill and Hansen (1960), he defines 'conceptual framework' as "... clusters of interrelated but not necessarily interdefined concepts generally applicable to the area of interest" (levant, 1984, p.9). On the other hand, 'theory' isdefined as "...a set of interrelated propositions which areempirically verifiable, universally valid, and parsimonious in theirexplanation of phenomena" (Rodgers, 1964 in levant, 1984, p.9).
The present state of confusion has important consequences. Primarily,any discussion at all of theory becomes difficultdueto a lackof consensus with regard to the basicconcepts as well as differences in terminology and emphasis among theorists. The absence of a common vocabulary does little to facilitate communication between theoreticians There has been much debate in the literature as to the desirability and usefulness or otherwise of this diversification (Kolevzon & Green, 1985). Some authors have viewed this variation as a necessary stage in the growth of the relatively young family therapy field and regard divergence as lending vitalityand flexibility to the process of knowledge expansion (Butcher & Strauss, 1961; Carlton, 1977; Vollmer & Mills, 1966, quoted in Kolevzon & Green, 1985). On the other hand, others argue for the development of an explicit, unified and more rigorous meta-theory of family therapy as a guiding principle for conceptual integration and further growth (Gurman & Kniskern, 1981; liddle, 1982; .Olson, Russell, & Sprenkle, 1980; Simon, 1980, quoted in KolevZon & Green, 1985; Weeks, 1986). However, over approximately the last five years, the family therapy field has been giving increased attention to the development of theory. A great deal of the new interest in' theory has been directed towards the developmentof a systems paradigm toguide clinical practice (Searight & Openlander, 1987). ' The current family therapy literature also reflects a concern with the concept of .,.~~" epistemology. As increasing attention is focused on this issue, a polemic has arisen ". ..". jr-c-, J between the so-called strategic and ecosystemic approaches to family therapy. The debate is rooted in a much earlier division between Jay Haley and Gregory Bateson in the early years of the Bat~Jrresearch-projecran(l'"refiectsfundamental differences between them.'·---·- Dell (1982) outlines tlie central issues of the debate- -1- Family Therapy: Strategic and Ecosystemic Approaches Strategic therapists who base their approach on the work of Erickson, Jackson, Haley and Watzlawick et ai, describe families in terms of patterns of interaction or in terms of the structure of the system. The clinical application of this approach requires that that they emphasize planned, strategic interventions, often employing paradoxes which are designed to alter or disrupt the existing family system (Dell, '1982). ~on-stra~. therapists have criticiz~4.!bj_~empbas~~J1 te<:bniq':l~.g~~fZ~!..!he~gic ~pists' technicaL'tocmula:~e~~oa~.~ .. ~~.~e~apy_d"~I)l().r1s~r_~!~s anjos-ensitivity-to-the the hj!man-feelingsof·individuaLf~mily.me~be~~l They in turn, accuse their critics of being nonsystemic, linear thinkers who areuna eto grasp the fundamental circularity that is described by the "newepistemology" (Dell,"1982, p.59). Keeney, (1982;1983a, etc), has entered the debate and criticises the strategic therapists at the level of epistemology. In his critique of the pragmatism and emphasis on technological power of the strategic therapists, Keeney revivesthe Bateson-Haley debate and argues instead for a more aesthetic approach to therapy based upon ecosystemic epistemology (Dell, 1982). . These issues will be addressed more fully in this study. The study will examine and compare the strategic and ecosysternic appr()Cl<:h~_tofarnily therapy in an attempt to establish whether real conceptual differences exist between them. The assumptions and central theoretical concepts underlying the two approaches will be described. The clinical methods of both approaches will be discussed and areas of divergence and/or similarityexplored. Itis not the purpose of this study to resolve areas of conflict between the two approaches, but rather to highlight and explore them. Since most workers in the family therapy field, including both strategic and ecosystemic therapists, claim to subscribe to a systems paradigm and thus use similar terminology, although not always with the same meaning, it becomes difficult to demarcate which concepts are specific or unique to a particular approach. For this reason, this study will focus on only one exponentfrom each approach, in the hope that clarity will be attained with respect to the differences, if any, which exist between the two approaches. Forthe purposes of thisstudy, Jay Haley has been chosen as representative of thestrategic approach. While there is/some debate in the literature as to whether Haley should be : termed a strategic or structural therapist, there is agreement that his work reflects a developmentfrom a concern with process and strategic interventions in hisearlier works, to a focus on form or structure in his later work. However, since the term "strategic therapy" was coined by Haley, and given his involvement with Bateson from the inception of the double-bind project, where the original ideas informing strategic therapy were developed, and later with the Mental Research Institute and the development of a strategic approach to family therapy, it is felt that Haley'Sinclusion as a strategic therapist isjustified. However, this study willfocus on his earlier work, particularly the ideas developed in Strategies of Psychotherapy (Haley, 1963) and Problem Solving Therapy (Haley, 1976). Hisassociation with Bateson also lends perspective to the areas of disagreement between them which are perpetuated in the debate between the strategic and ecosystemic therapists today. The ecosystemic approach is based on the work of Gregory Bateson and attempts to integrate Bateson's concern with ecology and epistemology in an approach to therapy which emphasizes cybernetic processes and circular causality. While Dell and Keeney -2- Family lherapy: Strategic and Ecosystemic Approaches have addressed the implications of Bateson's observations for family therapy, both describing therapy in terms of the creation of a new ecosystem, this study will focus specificallyon the work of Bradford Keeney as, of the two writers, he has developed the more encompassing and systematic theory. Firstly, however, in order to place the study .in context; it is necessary to review the development of the family therapy movement, specifically within the field of psychotherapy, and more generally within the broader context of developments in the natural and behavioural sciences. Chapter two will present an overview of the history and conceptual development of the family therapy field. Before a detailed discussion of the two approaches to family therapy is presented, the problem of "epistemology", its definition and use within the field of family therapy is considered in Chapter three. Chapters four and five, provide a detailed discussion of the underlying assumptions, central theoretical concepts and methodology of the Strategic and Ecosystemic ap proaches to family therapy, respectively. In Chapter six,the two approaches are compared along a number of critical dimensions, and finally a summary of the study as well as the conclusions drawn from the work are presented in Chapter seven. -3- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 2 - Historical Overview Family Therapy: Strategic and Ecosystemic Approaches 2.1 Introduction The early 1950's appears to be the date generally accepted in the literature as the beginning of the family therapy movement This mov~m~!!~~~~~rdsJrr~I~{>y~ith whole families occurred, as several authors have noted (Haley, 1971; Jones, 1980; Kolevson & Green,1985);-afatinle-when-tfiePsychoanalytic method, with its strong focus on the individual and intrapsychic dynamics, had gained acceptance as the treatment of choice within the Psychiatric establishment. In addition, the analytic principle of safeguarding the therapeutic relationship and preventing the "contamination" of transference, precluded the inclusion of significantfamily members in therapy. As Haley (1971) notes, often therapists treating wholefamllieswouldbepenalized byprofessional isolation. Thus the emergen~eonariiify_therapy_app~ars to be discontinuous with the prevailing views ofthemental health establishment at the time. 2.2 Change in ScientificParadigms In TheStructure ofScientific Revolutions, Thomas Kuhn (1970) describes the manner inwhich changes occur in dominantscientific paradigms. These changes do not represent a cumulative process of building knowledge, rather advances in knowledge appear as anomalies within the prevailing paradigm and are often incompatible with accepted views. 2.2.1 Periods of IInormality" According to Kuhn, (in Kolevson & Green, 1985), these transformations follow periods of "normalitY' during which a particular system of beliefs has become institutionalized within a particular scientific community. These belief systems provide a conceptual framework for explaining phenomena and solving problems. Consequently sensitivityto perception of anomaly islostand ideas thatappear to be incompatiblewith the prevailing paradigm are rejected. Expansion of knowledge is cumulative and research is aimed at ~ broadening of knowledge of already existing phenomena that is consistent with the prominent paradigm (lones, 1980). 2.2.2 The Emergence of Alternative Paradigms "Normaf' science does not aim at novelty of fact or theory (Kuhn, 1970). However, as Kuhn points out: "New and unsuspectedphenomena are, ...,repeatedlyuncovered by scientific research, and radical new theories have again and again been invented by scientists" (Kuhn, 1970, p.52). While these novelties tend to be produced inadvertently within the "rules" ofthe prevailing paradigm, in order to be assimilated, they require the development of a new set of rules and thus, of a new conceptual framework. The emergence of an anomaly which is incompatible with the prevailing paradigm leads to a crisis within the scientific community. New explanatory systems are required to account for the anomaly and thus scientists become open to alternative perceptions which were obscured by the previous environment of normality (lones, 1980). The resulting transition to a new paradigm is what Kuhn terms a scientific revolution, "... a -4- i' Family Therapy: Strategic and Ecosystemic Approaches noncumulative developmental episodein whichan olderparadigm isreplaced in whole or in partby an incompatible new one" (Kuhn, 1970, p.92). 2.3 FamilyTherapy As Paradigmatic Revolution It may be claimed that the emergence of the family therapy movement in the 1950's constituted such a revolution. In the terminology of Kuhn's model, the mental health profession in the 1950's was characterised by a state of normality. Psychoanalysis, the prevailing paradigm, had attained dominance and respectibility. The psychiatric estab lishment was concerned with expanding and developing the psychoanalytic method of treatment,and there was resistance to alternateforms oftreatment.Those using different methodswere frequently ostracized. 2.3.1 Psychoanalysis and the Medical Model The focus of psychoanalytic treatment was the individual. In addition, psychiatry being a medical specialty, therapywas viewed as a form of medical treatment. A basic tenet of the medical model was the idea that a "patient" could be "cured' of the underlying, innercauseof his ills ifhel:l were removed from his social situation and treated individually within a hospital or other institutional environment(Haley, 1971). 2.3.2 Research as the Impetus for Family Therapy Since anomaly in science tends to be introduced inadvertently by research, it is noteworthy that mostof the ideas that provided the foundation for the family therapy movement, emergedfirst under the guiseof research conducted bya number of mental health professionals in different partsof the United Statesand Europe. Itwas onlyafter family therapy was conducted under the rubric of research that family principles were used in treatment. The reluctanceto depart from the prevailing paradigm of individual treatmentalsopreventedresearchers from publishing theirwork in professional journals, so contributing to the isolcition of earlyworkers. 23.21 Live Observation Hoffman, (1981) attributes the growth of family therapy research to the use of live observation which enabled researchers and clinicians to observe for the first time, symptomatic individuals in their "natural habitat" - the family (Hoffman, 1981). In addition, the advent of the one-way screen, used to observe live family interviews, allowed researchers an alternate perspective where interactions could be viewed from more than one position. These advances opened new possibilities for conceptualizing symptomatic behaviour. The inequity of the traditional use of the masculine pronoun is acknowledged. Itis used in this study for reasons of convenience only•. -5- I Family Therapy: Strategic and Ecosysfemic Approaches 2.4 The Emergence of Family Therapy within Context It is ~Lexactly why several workers in different parts of the United States broke away from the established ideas regarding symptomatic behaviour and change, and moved towards workIng"with whole families (HaTey, 1971').. It is repeatedly argued in the literature that the family therapy movement emerged in response to frustration and dissatisfactionwith conventional psychoanalytic principles, particularly their ineffective ness in explaining and treating the phenomenon of schizophrenia (Ackerman in Acker man, Beatrnan & Sherman, 1967; Guerin, 1976; Kolevzon & Green, 1985; amongst others). However, if one views these developments within the broader context of developments inthe natural ClJl,d socialsciences, theshift becomesclearer. AsWatzlawick pOints out, 'scientificc~~~~ptu(llizations, inclYd.l(lgJ~s~~~i~~ri~~~.?rieS: are em~dedin the "Zeitgeist" or ep'i.stemology.of.!b~irera (in Watzlawick & Weakland, 1977). As such, the events which led-io··the evolution of the family therapy movement cannot be separated from the events characterizing the evolution ~f physical and biologicalscience in the twentieth century (Auerswald,1987). . . .. -~""_-.,: ..,._.., ....,_. 2.4.1 The Newtonian World View Until approximately the end of World War II, a traditional Newtonian epistemology I dominated Western thougfli- "BaSed on Cartesian thought and Newtonian laws, this "\" epistemology-postulates a material world which is essentially a rule-bound mechanism operating in terms of constant scientifically verifiable laws. In this view, the world constitutes an "objective reality' which is subject to direct observation and empirical] measurement (Jou~rt,"1"987). This epistemology assumes a duati$tic universe in which something iseither.true ornottrue in keeping withthe idea of an objective reality.Truth is seen as an a.!>s<>J~~e. The primary focus of investigation is a reductive analysis with an atomistic examination of entities in space and the progression of events in linear time. linear-time isviewed as real time in which one event is causative in relation to the next event (Auerswald, 1985). Atomism which is integral to the Newtonian epistemology, is a theoretical approach whichassumes that it"is Possible to reduce reality to basic units. Thisapproach posits that these entities are d1stiIJct from the wider system of which they form part and have e~s!~sive qualities, d!stinct from the other entities in the context (Schwartzman, 1984). 2.4.2 Psychotherapy within a Newtonian Paradigm Theatomistic and linear concepts of the natural sciences reached modern psychotherapy via the routes of the medical model, psychiatry, neurology and psychoanalysis (Joubert, 1987). Traditionally symptomatic behaviour has been explained by either a medical of psychodynamic model. In both models the locus of distress is seen to reside within the individual and attempts are made to find historical, causal explanations for symptomatic behaviour (Hoffman, 1981). The conceptof causality underlying these models isa linear one, following the Newtonian principle that all phenomena have a definite cause and a resultant definite effect with past events determining the present and the future in a direct ul1ilineaci~~~n. "T~~linear ancLhistoricall},-Q~!~nt~L.~i!h.an"und~r. standing oftfle individ'ual's past being a preconditioILfgLfhange in"the present (watZlawick&Weakland, 1977). -6- Family Therapy: Strategic and Ecosystemic Approaches 2.4.3 The New Science Since, approximately the mid-~~~tL~!h~ntury,a diff~r~p-~ epistemology began to take root. The shift.!Qt.tt~ideas is linked to de'yelopmentsin fields as apparently divergent as physics, biology, mathematics, anthropologyancrCYbernetics. ,- The most well-documented ev~ts in the PQy.~igli ,-~ci~nces that contributed to the developmentof the new epistemologywere ~~~~nck'sstudies of black body radiation and his qu.Cl~tum theory of energy, as well as E~t~in's expansion of the quantum idea and his theory of Rel~tivity. These theories did n~nto the prevailing N~~onI~n definition of realitY'irnd its basic concepts andlanguage were inadequate to describe these phenomena. However, it was recognized that the new science formed a basisfor a ne~_~~~_~tr_LJles for describing reality, (a new epistemology) and was useful not only in other branches ofsdence, but in other disciplines. This new epistemology defined tr.!ttbas he1!r~c.ltdi~r4e~:Hh~ eith~.r/c:>r dualism ofthe Newtonian epistemology which precluded the existence of morethim one reality in favour of a "l!othlarLd'.'.rul~, and thus allowed for the continued existence of the Newtonian paradigm, whose concepts still had heuristicvalue, although the latter lost its positionof prominence (Auerswald,1987). 2.4.4 Psychotherapy within an Alternative Paradigm These d~e!()Prnents in the physical sciences were followed by simU.~~ t.!~!1~f~rrnation@~QAit7 in O!!!~!.._~reas of thought, includingthestudy of human behaviour and behaviour change (Auerswald, 1985). The new epistemology represented a shift to a more "o.!K~'.!!smic" 0rutl?Ok. It is based on the ~.2ncept of inf()r!!l~tion - of order, pattern and negentropy. Its p[i':l~iples are derived from cybe!"f)~tics which views causality as a circular, feedback process' so that event A, for example, does not linearly"cause" event B, but inf9rmation about'event Bimpinges on eventA,which then affects B,etc., in a circle of events which ~9difye~ch other (Jackson,in Watzlawick &Weakland, 1977; p.5).lt isconcerned with the pr~~,ot~ommuni~!ionwithin systems, and thus is applicable not only to the world of physical objects, but also to Hying ~y'stems, including the human family (Watzlawick & Weakland, 1977). The evolution of organismic as opposed to reductionistic'', theories in several different f(' fields contributed to the broader acceptance of this new epistemology. Organismic i, theory calls for the study of the organizing principles or relationships that result when ; the entire entity is taken into consideration. Itsfocus is on'theentire entity and on the relationships that result from the dynamic interaction of the parts of the whole. With this perspective it ispossibleto take in'to accountgoal-directed behaviour of an organism, including growth and creativity. The development of and acceptance of o~ganiz.a.!ion ra~eductionism as the 4n~Rrinciple in science, also set the stage for the development of General SystemsTheory (Nichols & Everett, 1986). Reductionism refers to the analysis of complex systems or ideas in terms of the isolated components constituting such systemsor ideas (Concise Oxford Dictionary, 1976). -7- Family 1herapy: StrategiC and EcosystemiCApproaches 2.4.5 General SystemsTheory GeneralSystems Theory, formulated by L~~wig~rJ.J~_~~lanffy, a biologiS!!.!~_!!Je.1940's, represented an important development in the shift to the new. epistemology. First proposed inorder to overcom-e the difficulty of solving multivariate problemsina linear, mechanistic way, general systems theory offers a method- of understanding organized complexity byviewing phenomena as systems or setsof interacting elements.According to Goldenberg and Goldenberg (1980) general systems theory represents an ~ to providea comprehensive theoretical model embracing all living systems. Theyviewvon Bertalanffy's majorcontributionasthe provision of a framework for looking at seemingly unrelated phenomena and understanding how together they represent interrelated componentsofa larger system. Von Bertalanffy postulated a theoryof universal principles running throughthe individual sciencesand bringing us nearer to the goal of a unity of allsciences, including an integration of the natural and socialsciences. 2.5 The Contribution of Gregory Bateson ItwasGregory Bateson who provided the c~~P-tuallink between the thinking of family therapists and the epistemology ofthe new science (Auerswald, 1987). He was alsoone of the firstto introducethe idea that a ~mily mightbe analog~_~~to acybernetic system (Hoffman, 1981). In the 1j§O.'s Bateson led a research project on commlJnica!ion in which he and hisco-workers, (including Don Jackson, Jay Haleyand John Weakland), attempted to classify communication in terms of levels of meaning, logical type and learning. The research alsoincluded the studyof hypnosis and paradoxaswellas patterns of schizophrenic transaction. Thestudy culminated in the development of the "double bind'theory, (Bateson, Jackson, Haley& Weakland,1956), which in essence p-roposed that schizophrenia was the result of a particular type of family communication1:1. 2.5.1 Implications of the Double-Bind Research The double-bindstudygenerated a great deal of research on communication in families with schizophrenic members. However the major contribution of this work lay in its wider implications. It represented a shift and a whole new way of conceptualizing disturbed behaviour, and thus of treating it Disturbed behaviour was viewed as "... J disturbed communicative behavior that ismaintained and structured by interaction with i others in a social context" (Segal & Bavelas, in Wolman & Stricker, 1983, p.62). As several authors have pointed out, (Haley, 1971; Hoffman, 1981; Segal & Bavelas, 1983; Watzlawick, 1977)/family therapy was not simply an additionaltheory about the nature of human behaviour, but a paradigmatic shift~onceptualization to a new epistemology, paralleling the. shift in the other sciences. Bateson himself notes this phenomenon: Asa member of Bateson's research group, the double-bind project hada significant influence onthe development of Haley's strategic ,therapy. The study will therefore be discussed indetail inthe chapter on the strategic approach. -8- Family Therapy: Strategic and Ecosysfemic Approaches '7he increase in family therapy over the last twenty years denotes more than the introduction ofa new method and more than a mere shift in the size of the social unitwith whichthe therapist feels that he must deal. Indeed, the verychange in the size of the unit brings with it a new epistemology and ontology, that is, a new way of thinking about what a mind is and a new concept of man's' place in the world' (Bateson, 1971b, p.242). ~ 2.6 Expansion of the Family Therapy Paradigm At the same time that Bateson and his colleagues were studying the communication patterns of schizophrenics in California, a number of other clinicians were engaged in research on schizophrenia and the family. As has been mentionedearlier these workers proceeded independently of one another and without knowledge of the others' work. This phenomenon may be seen to reflect the paradigmatic shiftin epistemology which was taking placeat the time, in keeping with Hoffman's (1981) theory of an "epidemiol ogyofideas". Nichols and Everett (1986) note alongsimilar lines that when the "culture base"tl, is sufficiently established, the same discovery or invention may be made separately but essentially simultaneously by different individuals and groups. The result they describe as an "independent invention". They use this concept to explain why researchers and practitioners in various locations can be credited with similar "dis coveries" infamily therapywithout beingaware ofthe workof others (Nichols & Everett, 1986, p.5). 2.7 Early Researchers in FamilyTherapy While many researchers were involved in family research at thistime, it is beyond the scope of this study to givea comprehensive account of their work. Instead only those researchers whosework,according to the literature, has had the mostsignificant impact on the family therapy field, will be discussed. A perusal of the literature indicates that apart from the Bateson group,the mostfrequently discussed researchers includethe lidz group at Johns Hopkins and later, Yale; the Bowen group at the MenningerClinic, and lyman Wynne and his associates in Washington D.C. Each of these groups will be discussed briefly. 2.7.1 Lidz In the mid-1950's, unaware of the work of the Bateson group, Lidz and hisco-workers ~n-t<>'::f~ar~-:-!he~_Ielationship .between schizophrenia and the family. Using psychoanalytic__conceptS: iliey~conducted .liif~rviewswitt1a. sample of hospitalized schizophrenics and theirfamilies. The Lidz group identified somegeneral difficulties that seemed to becharacieristicoftherelationshipbetweenthe-schizophrenic-andhisor her A term theyborrow from sociology and anthropology meaning the knowledge level and the desire or need for a particular item. . -9- Family Therapy: Strategic and Ecosystemic Approaches family.These difficulties were related to the child's "identity formation". They found that in schizophrenic families, there often was a disturbance in generational boundaries and the parents provided inappropriate role models. These factors resulted in a failure on the part of the family to provide the essentials for integrated personality development and led to identity distortion in the child, which in turn became the psychological basis for schizophrenia. Lidz distinguished between two types of schizophrenic families, ''skewed'' and ''schis matic", on the basisof the type of disturbance found in the parents' marital relationship. In the skewed family, the marital relationship is characterized by a dominant-submissive pattern with the mother usually in the dominating role. In the schismatic family, on the other hand, the marital relationship is characterized by chronic hostility and mutual withdrawal. For Lidz, a lack of role reciprocity, which refers to flexible roles as opposed to rigid,stereotyped roles, ischaracteristic of a skewed or schismatic marital relationship (Okun & Rappaport, 1980). In both types of relationship, tension and confusion result in the child's identity being confused which leads to pathology. The major contribution of Lidz and his associates liesin the view thata schizophrenic breakdown does not occur in isolation, butdevelops in a pathological familysystem and is nurtured by the disturbed communication patterns within the system (Okun & Rappaport, 1980). 2.7.2 Murray Bowen Murray Bowen began his research on shizophrenics and their families in the early 1950's at the Menninger Clinic in Topeka, Kansas. Although Bowen, a psychoanalyst, began by focusing on the mother-child symbiosis, he later included some fathers in the research and by the mid-1950's he began to hospitalize whole families of schizophrenics for observation. later, he also began to look at the multi-generational transmission of emotional illness,and includedthe grandparents in the study of the family. 2.7.2.1 FamilyTriangulation A significant contribution of Bowen's to the family therapy field, is his concept of triangulation in families. This refers to a process which occurs in all social groups, where , twosomes form to theexclusion of, or against, a third (Hoffman, 1981). Bowen's research indicated that the parents of schizophrenic children tend to have poor marital relation ships characterized by emotional distance between the spouses. This leads to triangula tion when a child is born into the system. Since the parents have difficulty in relating to one another, the child is used to reestablish contact or deflect tension and so maintain a stable relationship between the parents. After a period of time the process of triangulation begins to follow distinct repetitive patterns. Triangles are not restricted to small segments of the family and may include members of the extended family or even of outside agencies. These triadic patterns are characteristic of all families. However, what distinguishes families with disturbed members is a rigidity of these patterns (Hoffman, 1981). 2.7.22 The Undifferentiated Family Ego Mass Another attributeof familieswith pathological members, isthatof a lack of differentiation. Bowen referred to the observation that such families exhibited an intense interdepen- -10- Family therapy: Strategic and Ecosystemic Approaches dence asthe "undifferentiated familyegomass" (Hoffman, 1981). For Bowen, the degree of differentiation within a family was a significant indexof pathology. 2.7.2.3 SChizophrenia as a Symptom of a Faulty Family System For Bowen, the family represents a number of systems and subsystems. Schizophrenia reflects a symptom of a faulty family system and in order to understand the patient's pathology, it is necessary to examinethe emotional system of the entire family system (Okun & Rappaport, 1980). An important contribution of Bowen's work to the family therapyfield was his viewthatsimilar processes operated,to different degreesinalltypes of families, both ''functionaf' and "dysfunctionaf'. He was thus a forerunner in applying hisfindings to families beyondthose of the schizophrenic population. 2.7.3 Lyman Wynne lyman Wynne and hisassociates observed families in family therapysituations in order to find a psychodynamic interpretation of schizophrenia that would incorporate the social organization of the family as a whole (Okun & Rappaport, 1980). 2.7.3.1 Mutuality, Nonmutuality and Pseudomutuality Wynnepostulated twoconflicting needsofthe individual: a)the need to developa sense of personal identity and b) the need to relate intimately to significant others. He identified three possible options with regard to fulfilling these apparently conflicting needs: 1 mutuality, in which the individual has a variety of self-interests and there exists a balance between the individual's andthe family's interests; 2 nonmutuality, where family relationships are highly superficial and there are no areas of common interest between the individual and the family; and 3 pseudomutuality, where the family insists on the individual maintaining a facade of intimacy within the family at the expense of individual identity. The latter is characteristic of families with schizophrenic members. (Another option is pseudohostility, where conflict exists among family members to cover up the need for intimacy.) 2.7.3.2 Family Boundaries and the "Rubber Fence- The Wynne groupalso developedthe concept of family boundaries, which refer to "... the individual'sidentity within the family, in relation to selfand to other familymembers, and to the family's identity as a unit unto itselfand in relation to a largersocial system" (Okun & Rappaport, 1980, pAl). Both personal identity and family boundaries are sourcesof confusion for the schizophrenic patient. Wynne observed that the boundary aroundthe family, although itappeared to be yielding, wasactually an impervious barrier against outsiders. Wynne termed this barrierthe "rubber fence". This confusion isexacerbated bythe families ofschizophrenics since rolesare either too rigidly or too ambiguously structured, preventing the identified patientfrom experiment- -11- Family Therapy: Strategic and Ecosysfemic Approaches ingwith a variety of roles necessary to achievesuccessful personal identity. The family insists upon the desirability and appropriateness of this role struture, and is unable to tolerate difference or dissent. The illusion of pseudomutuality reinforces the myth that allare linked togetherand the rubberfenceforms a boundaryaround thisillusion which protects the family from new information or potential change. Thus children in these families are unableto differentiate or disengage and inthe absenceofexternal validation, the unique communication styleof these families may lead to the thought disturbances characteristic ofschizophrenia (Hoffman, 1981).TheWynnegroupthus alsoconcluded from their research that in the case of schizophrenia, pathology resides in the entire family system and is evidenced in the way that family members interact (Okun & Rappaport, 1980). 2.8 The Contribution of Nathan Ackerman From the above discussion it is apparent that the early research focused heavily on schizophrenia. Itwasonly recognized in later studies that similar patternswere present in all families, although to different degrees. Itwas NathanAckerman, regarded as one of the most important founding figures of the family therapy movement, who began working with non-schizophrenic families in the founding decade of the family therapy movement. The workof Ackerman isalso regarded as representing the transition from research to the actual practice of family therapy (Okun & Rappaport, 1980). Although Ackerman wasa trained psychoanalyst, he wasgreatly influenced bythe work ofsocial psychologists such as Kurt Lewin and john Spiegel. As earlyas 1938, Ackerman wrotea paperentitled 'The Family asa Social and Emotional Unit", inwhich he observed that the family isa dynamic psychological and social unit in itself (Okun & Rappoport, 1980).Ackerman wasconcernedwith"man in hisenvironment" and believed that there is a dynamic interaction between man who is biologically determined and the social environment within which he interacts (cited in jones, 1980, p.16). The interaction between an individual and his social environmentinvolves the intrapsychic and inter personallevels aswellasthe interaction between the family and the larger social context. Theselevels are inextricably linked and noone componentcan be understoodinisolation from the others. 2.8.1 Social Role One of the important conceptsin histheory isthat of"social role", which provides a link betweenthe intrapsychic and the social aspectsofan individual's functioning. Ackerman definessocial roleas: "...the adaptational unit of personality in action" (cited in jones, 1980, p.18). This conceptwasadapted from john Spiegel who describedroles asdirected toward goals which may be defined, simultaneously from the point of view of the individual or from that of the social system. From the individual's point ofviewthisgoal may be referred to as motivation and from the social system's perspective, one maytalk of its"function" forthe system Oones, 1980). -12- Family Therapy: Strategic and Ecosysfemic Approaches 2.8.2 Complementarity, Conflict and Prejudicial Scapegoating In "Treating the Troubled Family' (1966), Ackerman outlined several other important conceptsin his theoryoffamily therapy.Theseinclude, "complementarity", "conflict" and ''prejudicial scapegoating'. Central to the concept of"complementaiity of family relation ships" isthe idea of nurturance whichisessential to the survival ofthe family. Ackerman sees thisas the quality of circular support, interdependence, and intimacy moulded by the need to understand and care for other family members (Ackerman, 1966, cited in Jones, 1980, p.18). However, not all family relationships are characterized by complementarity. When differences arise between individuals they mayadapt to these differences and grow, or the differences may leadto a conflict situation whichis''paralytic'' in that itleadsto arrest or distortion. Within the family, conflict refers to a clash of values regarding the goals and functions of family life. Conflict and complementarity of relations within the family occur at all levels, the intrapsychic, the interpersonal and that of the family in relation to the broader social context. For Ackerman, conflict at anyone level is reciprocally related to conflict at anyother level and anysuchtwo levels constitute a circular feedback system sothat interpersonal conflict affects intrapsychic conflict and viceversa. However, Ackerman believed that interpersonal conflict within the family was a prerequisite for a fixed pattern of intrapsychic conflict (Jones, 1980, p.19). Theconceptsof complementarity and conflict are related to dyadicinteractions. When conflict occurs as the level of the triad and becomesstabilized and chronic,Ackerman terms it ''prejudicial scapegoating'. This occurs when a family organizes its entire emotional life around one member and various roles are then taken on by different family members around this individual. Three roles are particularly prominent in the mechanism ofscapegoating: attacker, victim and healer. Different family members fulfil each roleat different points intime.Asa result the family groupisdivided intocompeting emotional alliances (Jones, 1980). 2.8.3 Viewof Pathology Ackerman perceived dysfunction or ''pathology'' within a family as the inability of family members and the family as a whole, to adapt to differences and change. In his terms, pathology constitutes a breakdown of rolecomplementarity, so that there isa declinein functioning on the part ofeacllinaividual and the family unitasa whole. Sucha decline infunctioning maytake one of two extremes: ' 1 either there isa progressive rigidification of family roles, so that receptivity to new social learning islowered and the rangeofexploration of newalternatives isreduced; or 2 there is an unstable, uncontrolled fluidity of role relations that threatens to bring confusion or loss of identity for both the family and its individual members. This leaves the family members excessively open to outsideinfluences so that it becomes difficult topreserve the identity of individual and family. Ackerman referred to .the family processes that represented these two extremes as ''symptoms'' which he defined as: "...a unit of relational adaptation that is irrational, -13- FamilyTherapy: Strategic and EcosystemicAppr~ches inappropriate, automatized, andrepetitive" (Ackerman,1966,cited injones, 1980, p.21). Symptomsoccur inonefamilymemberwhen interpersonal conflict becomes internalized to become intrapersonal conflict, by way of the circular feedback mechanisms present in family systems. In order to alleviate the symptom, the intrapsychic conflict must be reprojected back into the field of interpersonal interaction. - 2.8.4 Goal and Process of Therapy For Ackerman, the goal of family therapy is twofold. On the one hand, there isthe aim of dissolving pathological conflict and fear in thefamily; and at thesame time, mobilizing and developing residual, positive forces within the family so that members learn new ways of relating to one another. Family functioning is assessed in terms of role complementarity, conflict, and prejudical scapegoating. Unhealthy family alignments are disturbed and more appropriate relationships are developed. The therapist acts as a catalyst to reveal interpersonal conflicts and connects these with intra-personal conflicts. The aim is to shift the locus of pathology away from the identified patient toward the familysystem as a whole (lones, 1980). \. 2.8.5 Roles of the Therapist jones (1980) identifies three important roles that the therapist assumes in Ackerman's model, namely parent figure, instrument of realityJesting, and educator. As a parent figure thelheraplst offers emotional support and acceptance to each family member; as an instrument of realitytesting he allows each family member to develop a more realistic image of self and of otherfamily members; and finallyas an educator, the therapist offers the family alternative patterns of relating (lones, 1980). 2.8.6 Methodology In terms of clinical practice, Ackerman does not specify particular techniques of intervention, rather as appears to be the case with many of the !tgnificant figures in the field of family therapy, the personality and charisma of the therapist feature strongly in the process of change (lones, 1980). Ferber (1968) in a review of Ackerman's book "Treating the Troubled Family", describes Ackerman's interventions in the following terms: "One is not sureone knows what one shoulddo though one feels one hasbeen toldwhatto do bya great andcharismatic leader' (cited in jones, 1980, p.177). Similarly, Hoffman (1981) feels thatAckerman possessed an "...extraordinary ability to usehisown presence to inducechange" (Hoffman, 1981, p.224). 2.8.7 Theoretical Inconsistency in Ackerman's Position Ackerman's theoretical concepts reflect the influence of his psychodynamic training, however, hedid not use psychodynamic techniques in his clinical work. He also claimed that he did notespouse a wholly "systemic" view of the familysince hefelt systemstheory neglected both the individual and the importance of family values. In actual clinical practice his method of work is strongly suggestive of a structural approach. As Hoffman (1981) points out, an analysisof Ackerman's interviewswith families reveals that he works very much in the'nere-and-now", tracking the relationship sequences connected with the presentingsymptom and linkingsymptoms to dysfunctional familystructures. He uses -14- Family Therapy: Strategic and Ecosystemic Approaches various methods of blocking behaviours and repetitive sequences, and frequently challenges existing rules and structures within the family. Thesetechniquesare aimed at altering the existing structure of the family and as such are essentially systemic. Were Ackerman's theoryto beconsistentwithhisinterventions, hewouldhaveto acknowledge a greatersystemic influence in hiswork. - Inthe literature Ackerman's workissaidto representa transition between the prevailing psychoanalytic method and the shift to a more interpersonal conceptualization ofhuman behaviour and dysfunction. Ackerman attempted to include both intrapsychic and interpersonal concepts in his work. Thus, hiswork issaid to representan intermediary position in the shift from the old to the new epistemology. However, it has been emphasized inthe previous discussion that the shift to an interpersonal viewrepresented a fundamentally new way of conceptualizing human behaviour, based on different assumptions. As Watzlawick (1977) points out, given theirdiscordant and discontinuous nature, the two epistemologies are incompatible. Thus such a position appears to be untenable. WhileAckerman's work may presentcertain theoretical problems, his contribution to the developing field of family therapy may be regarded as significant, not leastdue to the fact that, given his respected psychoanalytic credentials, he did much to foster the acceptanceand legitimization of family therapy conceptswithin the psychoanalytic and psychiatric establishment of the time (Okun & Rappaport, 1980). 2.9 The Development of the Family Therapy Field 2.9.1 The Decade of the 1950's This decadewascharacterized byan orientation to research, withthe various researchers communicating on a purelyinformal basis. Itwasonly in 1957 at the annual meeting of the American Orthopsychiatric Association that the first national meeting of family therapists and researchers was held (Kolevzon & Green, 1985). The excitement generated by thisand subsequent meetings in the late 1950's led to a rush to practice and a proliferation of family therapy techniques, many of which were adapted from individually oriented psychoanalytic theory which formed the background of many of the new practitioners. However, when the entire family began to be viewed as the ''patient'', the need to develop new concepts and terminology became apparent (Okun & Rappaport, 1980). 2.9.2 Family Therapy in the 60's and 70's Thedecadesof the 1960's and 1970's sawcontinuedexpansion inthe practice offamily therapy. Anentirearmoury of innovative techniqueswas developed including, multiple family therapy; family therapy sessions at the homes of clientfamilies; multiple impact therapywhere thefamily interacted intensively witha team ofmental health professionals over a briefperiod; the inclusion of the extended family and social network in therapy ('network therapy,; immediate videotape feedback of therapysessions to families, and the introduction ofmore"physicaf' techniquessuchasfamily sculpting and choreography in therapy(Goldenberg &. Goldenberg in Wolman & Stricker, 1983). -15- Family Therapy: Strafegic and Ecosysfemic Approaches In terms of theoretical development, increasing attention was focused on systemstheory as the need for a paradigmatic shift in thinking required by family therapy became apparent. Systemstheory became increasingly predominant particularly after the death of Nathan Ackerman who had been largely responsible for the continuing focus on intrapsychic processeswithin a familycontext. Most attempts at theory building consisted of explanation by prominent practitioners of the theoretical bases of their particular methods. Here Minuchin's exposition of structural theory and Watzlawick et aI's paradoxical and strategic method are significant (Goldenberg & Goldenberg, in Wolman & Stricker, 1983). In their discussion Goldenberg and Goldenberg point out that two developments are. necessary for any set of therapeutic procedures to gain scientific respectability- 1 There must exist some cogent body of theory operationally stated and put into a form where its hypotheses can be tested, and 2 the effectiveness of the approach must be systematically researched and established (in Wolman & Stricker, 1983, p.86). While there were attempts at theory building in the decade of the 1970's, outcome research was meagre and plagued by methodological problems due to the unique issues raised by the problem of doing such research within the non-linear paradigm of systems. 2.9.3 The Current Status of Family Therapy In the 1980's family therapy has gained increasing respectability and recognition as an international movement, with training in family therapy an integral part of most clinical training programmes (Goldenberg & Goldenberg, 1983). The 1980's have also been characterized by increased attention to theory development, particularly the develop ment of the systems paradigm as a guide for clinical practice (Searight & Openlander, 1987). As Dell (1982) points out, while the family therapy field was always loosely allied with some form of systems theory, in the early 1980's some new, explicitly systemic approaches to therapy evolved. These include the approach of Selvini Palazzoli and her .colleagues in Milan (1978), and Hoffman and her colleagues at the Ackerman Institute jn New York, (1981). 2.9.4 The Issue of Epistemology and Family Therapy The concern with epistemological issues in family therapy has been discussed in the previous chapter. Aside from the interest in epistemology generated by the debate between strategicand non-strategic therapists, Dell (1982) identifies a numberof reasons for the importance of this concept to the field at the present time- Asthesystemic therapies basedon Bateson's conceptof epistemology, (the Milan school and Hoffman), became more popular, it evoked a general interest among family therapists in Bateson's original conceptualization of epistemology, particularly following his death in 1978. The new epistemology also appealed to those therapists who were interested in more rigorous attention to the usually neglected area of theory in family therapy. -16- Family Therapy: Strategic and Ecosystemic Approaches In the following chapter the concept of epistemology as well as itssignificance for the family therapyfield will be clarified. -17- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 3 - Epistemology Family Therapy: Strategic and Ecosystemic Approaches 3.1 Introduction Familytherapy represents one of the few fields in the behavioural sciences that has given serious attention to epistemological issues(Auerswald,1987). Gregory Bateson iscredited with introducing the concept into the field of family therapy. As Dell points out, Bateson was committed to the idea that epistemology is crucially important to all human endeavor. Moreover, Bateson used the term in relation to a systemic view of the world. He described human interactions in terms of systems theory and cybernetics, and discussed systems theory in terms of epistemology. It thus appeared to be a natural step for family therapists who were generally advocates of some form of systems theory, to adopttheterm (Dell,1982). However, as Keeney (1982b) points out, with the increasing use of the term within the family therapy field, there are a variety of explanations of its meaning and much confusion and disagreement with regard to its "proper identity". 3.2 Defining"Epistemology' The term 'epistemology' isderived from theGreek 'episteme' meaning 'knowledge', and 'logos' meaning 'discourse', and refers to the "theory of the method or grounds of knowledge" (Concise Oxford Dictionary, 1976, p.349). Dell (1982) describes epistemol- . ogy as a branch of philosophy which investigates the origin, nature and limitations of knowledge. Similarly for Keeney (1983a), epistemology within the contextof philosophy, refers to aset of analytical and critical techniques that defines boundaries for the processes of knowing (Keeney, 1983a, p.13). According to Falzer (1986) epistemology was founded in order to transform the metaphysical roots of philosophy. Metaphysics is concerned with the attempt to com prehend the ultimate nature of realityand existence (Gouws, louw, Meyer&Plug,1979). Falzer credits Kant with transforming philosophy from its metaphysical basis into a foundational discipline concerned with the way by which knowledge is discovered. In this way philosophy was able to retain its relevance and influence at a time when the sciences were taking over its position in dealing with knowledge of factual existence .(Falzer, 1986). 3.2.1 Definition of the Term within the Family Therapy Field Held and Pols (1985), in an attempt to clarify the confusion about the meaning of the concept within the field of family therapy, distinguish two meanin of the term 'epistemology'. They attribute much of the confusion surroundin the_ter ~n unconventional usage of the term by writers in the familytherapy-field, w ich isdifferent frOi!i1ts prevailing m~aning within the discipline of philosophy. On the one hand, as it isconventionally understood as a phil~rm, 'epistemology' refers to a discipline which is concerned with the nature of knowledge, that is, with what knowlege is, and how it is obtained as opposed to mere belief or prejudice. On the other hand the less conventional meaning of the term refers to whatwe know or think we know. This usage is common in the family therapy literature and is concerned, among other things, with such matters as free willand deteminism, and consequentlywith the problem of causality (Held & Pols, 1985).' , -18- Family Therapy: Strategic and Ecosystemic Approaches 3.2.2 Epistemology, Ontology and Metaphysics Held and Pols claim that in this latter sense, 'epistemology' is in fact "metaphysics" or "ontology", where 'metaphysics' in its common usage refers to what is or is not real in some fundamental sense and 'ontology, to the nature of being. Once the question of knowing reality is posed, however, we are concerned once more with the philosophical -orconventional-meaningofthe term 'epistemology'. This relationship between the two meanings of the term accounts, according to Held and Pols, for much of the confusion regarding 'epistemology '(Held & Pols, 1985, pp.510-512). 3.2.3 "Epistemology" as distinct from "Theory" and "Paradigm" At this point it is necessary to distinguish the term 'epistemology' from 'theory' and 'paradigm', terms with which it isfrequently confused. "Iheory' refersto a set of logically interrelated propositions which are presented as an explanation for a set of related phenomena (Gouws et aI, 1979, p.304). Given that epistemology has to do with the question of knowledge -what it isand what it ispossible to know - it isconcerned with how theories are constructed and whatvaliditythey have. For Rayner (1986), epistemol ogy sets out how we can legitimately specify axioms, the building blocks of theories (p.127). Epistemology and theory thus represent different logical levels. Following Kuhn (1970), the term 'paradigm' refers to a conceptual scheme which is fundamental to a given science or group of sciences and thus indicates a basic manner of thinking or approach which iswidely accepted by all practitioners of a specificscience (Kuhn, cited in Van Zyl, 1985). For example, one may refer to a Newtonian paradigm of the world or an Einsteinian paradigm. Keeney regards 'paradigm' to be synonymous with 'world view', 'general orientation' or 'universe of experience' (Keeney 1982b, p.155). Auerswald (1987) defines these terms in the following way: 'Epistemology' refers to a set of rules used by a specific group of people to define reality. 'Paradigm' denotes a set of rules used by a specific group to define a sub-unit of reality, and 'theory' refers to an idea or set of ideas that actually or potentially contribute to a paradigm (Auerswald, ·1987, p.321). ~~~ '- 3.3 Epistemology and Family Therapr:~' w .----~ As Dell-(1982) and Rayner (1986) point out, within the field of family therapy the term 'epistemology'israreJY used in its"correct" philosophical sense. Rather, most writers in thisfield when usingthe term 'epistemology', actually mean 'paradigm' as defined above. Thus, according to Dell, the "new epistemologies" are not new theories of knowledge, but new paradigms. Similarly for Rayner those who talk of "experimental epistemology" or "clinical epistemology" (Rabkin,1978), "...violatfe] ...terminology" byconfusing 'theory' and 'epistemoiogy'" (Rayner, 1986, p.127). Dell attributes the altered meaning of the word to Bateson. While Bateson used the term in a variety of different ways, the meaning which caught on in the family therapy field is 'epistemology' in the sense of 'paradigm' (Dell, 1982). -19- Family Therapy: Strafegic and Ecosystemic Approaches 3.4 Bateson and Epistemology Bateson referred to hisworkas epistemology and to himselfas an epistemologist (Keeney, 1982b). In the tradition of the so-called 'experimental epistemologists', (including McCulloch, Maturana, Varela, Von Foerster who worked in the area of neurophysiology and Piaget, who was concerned with how children organize processes of knowing), Bateson in hisstudy of natural social groups, contributed to transposing the philosophical discipline of epistemology to the domain of empirical science, by the investigation of human epistemological processes (Van Zyl, 1985). This work represented a shift from the paradigm of matter to thatof information or pattern and isconcerned with identifying the patterns of organization thatcharacterize mental and living process (Keeney,1982b). 3.4.1 Use of the Term "Epistemology l in Bateson's Work Dell (1985), notes that Bateson's work on the subject of 'epistemology' is difficult to understand as he uses the term in at least five different ways, namely 1 Epistemology as theory ofknowledge In this sense the term corresponds largely to the traditional meaning within the bounds of philosophy. 2 Epistemology asparadigm Epistemology-as-paradigm (or Weltanschauung> appears to be the usage that has become most popular in the family therapy field. Although Bateson did not specify exactly what he meant by this usage, Dell (1985) proposes that an epistemology in the sense of paradigm provides a grammar of reality and specifies how the objects and events of the world should be punctuated. 3 Epistemology asbiological cosmology For Bateson, the fundamental characteristic of biological systems is that they possess the ability to know, think, and decide. In other words they posses the properties of mind and are therefore inherently epistemic. Bateson (1979), specified sixcriteria of mind- a A mind is an aggregate of interacting parts or components. b The interaction between parts of mind is triggered by difference. C Mental process requires collateral energy. d Mental process requires circular (or more complex) chains of deter mination. , In mental process, the effects of difference are to be regarded as ~ transforms, that is, coded versions of events which preceded them. -20- ca '" rC Family Therapy: Strategic and Ecosysfemic Approaches f The description and classification of these processes of transforma tion discloses a hierarchy of logical types immanent in the phenomena (cited in Dell, 1985, pp.2-3). According to Bateson, the personal knowing of any given organism is "...a small part of a widerintegrated knowing that knits the entire biosphere or creation" (cited in Dell, 1985, p.3). He saw all livingcreatures as connected by and at the same time, constituting, the epistemicwith the''pattern thatconnects" being epistemology. Thus biology and ecology are epistemology. 4 Epistemologyas science Bateson considered epistemology to be "...an indivisible, integrated metascience whosesubjectmatteris the worldof evolution, thought, adaptation, embryology, and genetics" (Bateson, 1979, cited in Dell, 1985, p.3). Epistemology, for Bateson isthus a science, specificallya branch of natural history. He defined epistemological science as "...thestudyof how particular organisms oraggregates of organism know, think, and decide" (ibid). In particular Bateson believed that livingorganisms do not obtain objective information about the world around them and one could not know the "thing-in-itself'. In this area he had been influenced by the work of McCulloch and Maturana on perception, specifically the idea that neurophysiological structure contained the mechanism which prevented objective information from being trans mitted to the observer. Thus a major requirement of epistemological science is to adequately describe the impossibility of objectivity. 5 Epistemologyas characterstructure Bateson believed that character structure isone's own personal epistemology. In his paper "The Cybernetics of 'Self': A Theory of Alcoholism", Bateson (1971) described the relationship between epistemology and ontology. Ontology concerns the study of the nature of being. For Bateson it represents the study of "how things are, what isa person, and whatsortof a world thisis"and epistemology the study of "howwe know anything, ...how we know whatsortof a worldit isand what sortof creatures we are thatcanknowsomething(or perhaps nothing) of thismatter," (Bateson, 1971, p.t). However, for Bateson, these concepts are inseparable in human natural history since man's beliefsaboutwhatsort of world it isdetermines how he perceives itand acts within it. In turn his ways of perceiving and acting, influence his beliefs about its nature. He claimed thatcharacter structure is,"...a net ofepistemological and ontological premises", which specifies how the person must understand and relate to the world around him (Bateson, 1971, p.2). Similarly, he used the term "epistemology" to cover both aspects which together referred to a body of habitual assumptions or premises implicit in the relationship between man and environment, or "...a net of premises which govern adaptation (or maladaptation) to the humanandphysical environment," (Bateson, 1971, pAl. For Bateson, it isimpossible for one not to have an epistemology: "AU descriptions are basedon theories of how to makedescriptions. You cannotclaim to haveno epistemol ogy. Those who so claim havenothingbut a bad epistemology. And everydescription is based upon, and contains implicitly, a theoryof how to describe," (Bateson, cited in -21- l Family Therapy: Strategic and Ecosystemic Approaches Keeney, 1979, p.118). Keeney (1983a) disagrees with Bateson here inasmuch as he prefers not to categorize an epistemology as "bad". For Keeney rather, the claim to have no epistemology reveals an epistemology that does not include a conscious awareness of itself. 3.4.2 Epistemological Errors While other authors (for example, Keeney, 1983a) contend that epistemologies, by definition cannot be either true or false, Bateson insisted that an epistemology could be false. He referred to "epistemological mistakes", "epistemological errors", "epistemologi cal fallacies" and "incorrect epistemologies". He proposed that human psychopathology isfundamentally rooted in epistemological errors such as believingin objectivity,ignoring the circular nature of systems and attempting to control any part of the system to which one belonged. Bateson's rejection of the notion of power has been well documented. For Bateson, these ideas were in disagreement with how the world is and thus, were anti-ecological. 3.5 Keeney's View of Epistemology Bradford Keeney elaborated upon Bateson's ideas on epistemology. He too acknow ledges usingthe term 'epistemology' in a double sense- 1 indicating how one thinks, perceives, and decides, (in keeping with its use within the field of philosophy), and 2 what one thinks, perceives, and decides (in other words referring to 'paradigm'). For Keeney,as for Bateson, how one knows isinseparable from whatone knows (Keeney, 1983a, p.17). 3.5.1 Drawing Distinctions For Keeney the most fundamental act of epistemology involv~g.adistinction-or ?teating a differenee- (Keeney, 1982b; 1983a). It is o"-lrJl1rough_distinguishing one pa~r!dromanotherJh~~~eare able to know or understand phenomena. Forexample, -Watzlawicketa/. (1974), quote Whorf's proposal that in a universe in which everything is blue, the concept of blueness cannot be developed until contrasting colours are distinguished (Watzlawicket a/., 1974, p.2). Understanding phenomena involves know ledge of the distinctions which formed the basis of their creation. Drawing distinctions thus serves as thestarting point for any action, decision, perception, thought, description, theory, and epistemology; and is a way of constructing and knowing a world of experience (Keeney, 1983a). -22- Family Therapy: Strategic and Ecosystemic Approaches 3.5.2 Observation and Description Distinctions are drawn by observers (in order to observe). By the act of drawing distinctions, an observer creates boundaries which organize events in a particular way and determines how he experiences his world. What he perceives and thus knows is based upon how he draws distinctions. These observations can be described. Thus descriptions involve the drawing of distinctions upon what we observe. This process is recursive in nature. In order to observe it is necessary to draw distinctions and similarly, we draw further distinctionsin order to describe whatwe observe (Keeney, 1983a). The tool by means of which distinctions are imposed upon our world and described, is language. \. 3.5.3 Punctuation Bateson referred to the activityof organizing experience by means of the distinctions we draw as ''punctuation" (Keeney 1982b). The formal study of the ways people punctuate their experience enables one to identify their epistemology (Keeney, 1983a). Ibis bas ~cations for the c1ir~i9I.sjtuation_lnorder.for-a.therapisttounderstand.an indUlid!J~I's experience .it is necessa..!Y. foLhim.J:o-..l!nderstand the client's h~bituaLmanner of f5Unct~.his world. Inother words, theJh~r 3.6 Critique of Keeney's Position / For Rayner a meta-epistemology constitutes a "...violation ofterminology ofthe highest order..." (Rayner, 1986, p.127). This is so, since by definition epistemology deals with the limits of what it is possible to know and therefore cannot be subsumed under .something greater. He suggests that Keeney confuses 'epistemology' with 'paradigm'. Falzer (1986) also points out that by making epistemology a scientific rather than a philosophical concept, Keeney and others involved in this endeavour have made the epistemological movement in family therapy vulnerable to criticism from philosophers (Falzer, 1986, p.357). Guttman (1986), proposes that the preoccupation with epistemology simply represents a power struggle with various groups each claiming to represent the 'true' epistemology or the 'true'systems therapy, which in itself reflects a misunderstanding of the concept 'epistemology'. 3.7 Conclusion' From the above discussion it is apparent that the debate concerning epistemological issueswithin thefield of familytherapy remains contentious and confusing and to a large -23- Family Therapy: Strategic and Ecosystemic Approaches degree reflects the lack of clarity and confusion inthe use of the term bysuch influential writers in the field such as Gregory Bateson. Finally, itisimportantto notethat indiscussing epistemology or the processes ofknowing, one isoperatingfrom a particular paradigm or epistemology. As Keeney states:"Knowing aboutanepistemology also invokes anepistemology and canserve as a paradigm for the very process of epistemology" (Keeney, 1982b, p.165). -24- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 4 - The Strategic Approach Family Therapy: Strategic and Ecosysfemic Approaches 4.1 Introduction While opinions differ as to the major exponents of this approach, Milton Erickson, Jay Haley, the Mental Research Institute group, as well as the Milan school in Italy, are associated with strategic family therapy. The latter three approaches are considered to have emerged specificallyfrom the work of the Bateson research project of 1952-1962 (MacKinnon, 1983). In this chapter the strategic approach to family therapy will be discussed with specific reference to the work of Jay Haley. As mentioned earlier, there is some debate in the literature with regard to the inclusion of Haley as a purely strategic therapist While Stanton (1981), Madanes (1981) and MacKinnon (1983), for example categorize Haley as a strategic therapist, Hoffman (1981), on the other hand regards him along with Madanes, as a bridging figure between the strategic and structural positions with his different works placing emphasis on either of the two positions. Hoffman (1981), views the development of Haley's work over time as representing ''strange leap[sl' from process to form (Hoffman, 1981, p.280). She sees most of hiscareer as an oscillation from one side of Bateson's zigzag to the other. His early studies of schizophrenic communication which emphasized process were followed by research on coalitions in families, reflectinga concern with form. He then moved to the development of a strategic model for therapy which was once more process oriented. Followingthis his interest moved to form once again with the developmentof a structural familytherapy model with Minuchin and colleagues at the Philadelphia Child Guidance Clinic. The concern with an organizational model for therapy continued to dominate his later work. This study will concentrate on Haley's early works only. Haley's approach to family therapy will be discussed broadly in terms of the following criteria: 1 Underlying Assumptions 2 Theoretical Concepts 3 Methodology First, however, a definition of strategic therapy will be given and the early influences on Haley's work discussed. 4.2 Definition According to Haley (1973) "...therapy canbe called strategic ifthe clinician initiates what happens during therapy and designs a particular approach for each problem" (Haley, 1973, p.1?). Strategic therapists take responsibilityfor directly influencing people. While strategic therapists acknowledge that the therapeutic process reflects the mutual in fluence of both client and therapist, they stress that the initiative for effecting change is largelytaken by the therapistwhose duty it isto identify solvable problems, set goals and design interventions to ,achieve these goals (Haley, 1973). They strive, at least temporari- -25- Family Therapy: Strategic and Ecosystemic Approaches Iy, to enhance their influence over an interpersonal system in order to bring about beneficial change (Stanton, 1981). 4.3 Influences on Haley's Work 4.3.1 Early Influences TheworkofJayHaley strongly reflects the influence of bothGregory Bateson and Milton Erickson. According to Stanton (1981) the double-bind, togetherwith communications and cybernetic systems theory and studies by Haley and Weakland of Milton Erickson's hypnotic and therapeutic techniques, formed the basis for the development of the strategic approach to therapy. 4.3.2 The Work of Milton Erickson Haleyfirst met Milton Erickson in 1953 when he attended a seminar of Erickson's on hypnosis. Haley then included the communicative aspectsof the hypnoticrelationship in hisresearch and beganto visit Erickson regularly. This association continued for many yearsand Erickson's brieftherapywhich included hypnosis and paradoxical instruction, strongly influenced Haley's own style of psychotherapy. With the development of the new field offamily therapy, Haley beganto use Erickson's approach withina framework of family theory as he felt a family orientation was implicit in Erickson's work (Haley, 1973). Haley acknowledges the enormous influence of Erickson on his work and as Stanton(1981) notes, he feels that almostallof the therapeutic ideasapplied instrategic therapyhad theirorigins in Erickson's work insome form (Stanton, 1981, p.362). Indeed itwas inUncommon Therapy, his bookon the clinical workof Erickson that Haley coined the term "strategic therapy". 4.4 The Double Bind Project In order to describe the assumptions underlying Haley's approach, it is necessary to examinein moredetailthe developmentof his ideaswithin the field of communications, particularly hisassociation with the Double Bind project, (1952~62). 4.4.1 The Impetus for the Project Gregory Bateson had participated, together with NorbertWeiner and others in a series ofMacyFoundation conferences immediately afterWorldWar II, from whichdeveloped the field of cybernetics, incorporating ideas in systems and communication theory. Bateson, an anthropologist had been particularly interested in the way cultures per petuate themselves and this interest was carried into the study of individuals with his idea that the perpetuation of learning situations in a person's life provide the ongoing framework within which he learns. He believed that learning is not a single-level phenomenon, but a person also learnsto learn. His interestin levels of learning as well as in levels of classification systems led to the initiation of the double-bind project. -26- Family Therapy: Strategic and Ecosystemic Approaches 4.4.2 The Directiveof the Project Specifically, the project was given a two year grantfrom the Rockefeller Foundation to investigate paradoxes in communication. In that first year diverse phenomena were studied, including otters playing; the training of guide dogsfor the blind; an analysis of a popular film; the filming of Mongoloid children in a group; an analysis of humourand a ventriloquist and puppet,as well as interviews witha schizophrenic patient In general, the project was concernedwith analyzing various complex human and animal activities intermsoflevels ofcommunication, and in particular, focusing upon the possible conflict which can occur between a message and a qualifying message so that paradox occurs (Haley, 1981). For example, a statement on a signboard reading: ''All statements on this signboard areuntrue, "expresses a self-contradictory statementor paradox(Example from Hoffman, 1981, p.28). 4.4.3 The Investigation of Schizophrenic Communication When the Rockefeller grantwas not renewed in1954, itwasdecided to applyfora grant to investigate the area of schizophrenic communication. The research proceeded on the basis of two general assumptions, namely: 1 schizophrenics have difficulty in discrimination between 'reality'and fantasy, and 2 they have difficulty in the use of nonverbal and implicit signals. The aim of the investigation was to studythe schizophrenic's use of what they termed "reality qualifiers", that is, the 'rnetamessages' which frame or qualify other messages. Metamessages indicate what sort of message another message is and may be verbal, nonverbal or be indicated by vocal intonation or the physical context in which the message issent The messages qualifying each other are of different logical levels. 4.4.4 Conflict in Levels of Message and Paradox as a Basisfor SChizophrenia The researchers were primarily concerned with the conflict between these levels since ·itwas in thisconflict that paradoxwas generated (Haley, 1981). In the investigation of thisconflict, the importance oflearning to interpretthe communication ofothersbecame evident and the investigators then suggested conflict in levels of learning as a base for the developmentof schizophrenia: "It is suggested that the base for later psychosis may be laid in infancy by the experience ofdealing witha mother who both punishes the child for certain actions andpunishes the childfor learning thatpunishmentwill follow those certain action, i.e.,she generates paradox in the childby combining negative learning with negative D deutero-learning ." (Quote from grant application, Haley, 1981, p.10). xx 'Deutero-learning' is explained byBateson as "learning to learn" (Haley, 1981, p.9). -27- Family Therapy: Strategic and Ecosysfemic Approaches In other words, paradox occurs when, for example, a child is punished both for some action and punished when he shows by avoiding this action that he has learned that it would be punished. 4.4.5 The Concept of Family Homeostasis In 1954 Don Jackson joined the project. He was interested both in the interpersonal relationshipsof schizophrenics as well as cybernetics. Jackson had coined theterm ''family homeostasis" to descr~ th-iLQbstjniLcy_with-which--change-was-r.esisted-by family ...!!'embers wh~iz.Q~.!!!c patient improved. He depicted family interaction as "...a closedinformation systemin whic"f7Vatiation5 in output orbehavior are fed backin orderto correct the system's reponse" Oackson, 1957, cited in Hoffman, 1981, p.20). Haley later elaborated on this: "...ongoing relationships between intimates can be described in terms of a cybernetic analogy - people function as ''governors'' in relation to each other by reacting in "error-activated" ways to each other's behaviour....Granting thatit isthe function of a governor to diminish change, then the first lawof relationships follows: When one person indicates a change in relation to another, the other will act upon the first so as to diminish and modifythat change" (Haley, 1963, p.189). 4.4.6 Towards a Theory of Schizophrenia In 1956the project published its now famous paper "Towards a Theory ofSchizophrenia" (Bateson, Jackson, Haley & Weakland, 1956). The paper was defined as a preliminary summary of the team's communication theory of the origin and nature of schizophrenia. According to Haley, the central thesis of the theory was that there is a discontinuity between a class and its members, both being of different logical types, so that the class cannot be a member of itself nor can one of the members be the class. However, in human communication this discontinuity isinevitably breached. Pathology occurs when certain formal patterns of this breaching occur in the communication between mother and child, which at its extreme will have symptoms whose formal characteristics meet the criteria of schizophrenia (Haley, 1981). 4.4.7 The Concept of the Double Bind "Double bind" describes, accordingto Hoffman (1981), a contextof habitual communica tion impasses imposed on one another by persons in a relationship system (Hoffman, 1981, p.20). In the original article formal conditions were set as prerequisites for a pathology producing bind- /l} A primary negative injunction, "Don'tdo that." ~) Asecondary negative injunction at another levelwhich conflictswith the first: "Don't -' listen to anything Isay" (perhaps conveyed by tone of voice or manner). An injunction forbidding comment (usually nonverbval cues reinforcing rules that no longer need to be made explicit) and another forbidding the person to leave the field, (often delivered by context, as when the person is a child). -28- Family Therapy: Strategic and Ecosystemic Approaches 4 A situation that seems to be of survivalsignificance, so that it is vitally important for the person to discriminate correctly among the messages. 5 Aftera pattern of communication containing theseelements has become established, only a small reminder of the original sequence is needed to produce a reaction of panic or rage (Hoffman, 1981, pp.20-21). 4.4.8 Applications of the Double Bind Theory of Communication The possible therapeutic use of the double bind were also first suggested in the paper. An example was used from the work of Dr Fromm-Reichman treating the delusion of a patient as real while indicating that it is not, and so forcing a patient to respond to her (Haley, 1981).In addition, while schizophrenia was emphasized in the paper, the double bind was also offered as a means of analyzing and describing several areas of human activity in terms of levels of communication - for example, play, humour, ritual, poetry, fiction, and hypnosis. 4.4.9 Direct Observation of Schizophrenic Families in Interaction It is important to note that until this point the theory was based on hypothetical deductions with no first-hand systematic recording of parents and schizophrenic patients in interaction. It was not until Haley observed that a young patient had severe anxiety attacks every time his parents visited him, and began interviewing the parents jointlywith the patient, that the hypotheses about the development of schizophrenia began to be confirmed by the study of the recorded interaction of parents and child (Haley, 1981; Hoffman, 1981). With the shift to observations of actual family behaviour it became evident that a theoretical model to describe family interaction was needed as well as a descriptive language. Consequently a more detailed examination of linguistics was undertaken by the investigators (Haley, 1981). 4.4.10 Critique of the Double Bind Theory Haley cites a number of criticisms of that original attempt to introduce the concept of levels into psychiatry- 1 The impression was given that the double bind was a clearly definable, countable sequencewhich occurred in human relations. However, Haley points out that today it would not be considered as so clearly distinguishable given the complicated network of multiple levels of message in human communication. 2 The paper was ambiguous regarding the limitation of double bind sequences to schizophrenic learning contexts. The researchers agreed that these sequences may form a part of the etiology of other pathologies or even part of normal human interaction, with schizophrenia being a special case of systematic patterns of that conflict. \ -29- Family Therapy: Strategic and Ecosystemic Approaches 3 The double bind was presented as largely a two person interaction with one individual, the victim, facing conflicting levels of message imposed by another, usually the mother. 4 Haley also admits some ambiguity in the paper which he 'feels was related to differences in view developing within the project. While the paper defined the double bindas a contextitalso referred to a statementabout the subjective state of the ''victim'' SUffering feelings of helplessness, exasperation, and rage, whereas his behavioural response to the double bindwasnotdescribed (Haley, 1981, pp.14-16). The reception ofthe paper inthe scientific community revealed difficulty ingrasping the fundamental difference inapproachconveyed bythe concept ofconflict of logical types as opposed to a typical conflict-learning situation where the recipient may choose between "two evils". Similarly the double bind was seen as synonymous with am bivalence as withan individual who isfaced with choices of equal or near equal value to him. The double bind, however refers to an impossible situation where no choice is possible. 4.4.11 An Interpersonal Context for the Double Bind Originally the Double Bind was presented as a unidirectional transaction, the product ofan individual's motivational conflicts. Theinvestigation nowshifted itsfocustodescribe the interchange ina system of two or more people. In particular the researchers looked at describing the contribution of each individual to the pattern of sequences which occurred. Thusit became necessary to postulate a function for the double bindwhich involved at least two persons rather than merely the motivation of one of them. For example, while the mother of a schizophrenic child might be imposing conflicting injunctions, these were responsive to what the child was doing(Haley, 1981). Haley developed this idea further. Based on his homeostatic model which presented human relationships as governed, self-corrective systems, he proposed that people in a relationship control the range of each other's behaviour just as the governor in a cybernetic system controls the range ofthe elementsinthatsystem. Inthiswaythedouble ,bind couldbe seen to havea function which included both participants ina relationship: "...the double bindcouldbe seen asa tactic in the interchange between two people as they each attempted to gain control of the range of the system. Byimposing a double bind, a person can effectively prevent another from governing whatsort of relationship they will have" (Haley, 1981, p.23). In non pathological relationships the participants workout areasoftheir life togetherwhere it isagreedthat each isincontrolofwhat sort of relationship they will have. In pathological relationships they may become involved in a constantstruggle overwho isto determinewhat type of relationship theywill have, as isthe case withthe schizophrenic family. 4.4.12 Haley's Organizational Model of the Schizophrenic Family In 1959 Haley published "The Family of the SChizophrenic: a Model System" which was an attempt to demonstrate how schizophrenic behaviour isadaptive to a particular kind of family system. In this paper he suggested that in such families each member communicates conflicting levels of message, so that there could be no stablecoalitions amongmembers, no clearleadership inthe family and no clearstatementoffamily rules. -30- Family Therapy: Strategic and Ecosystemlc Approaches Haley argues therefore, thatthe incongruences whichoccurat alllevels inschizophrenic communication are habitual responses adaptive to conflicting rules at all levels in the family. He proposes a two-level homeostatic system- a At the first level, the family members respond in an error-activated way to any breaking of family rules by other members, and so govern each other's range of behaviour. b Atthe second level they each attempt to be the one who setsthe family rules, and. respond in an error-activated wayto attempts bythe othersto set family rules. Each family member disqualifies any attempt by another to govern his or her behaviour, which accounts for the high degree of conflict and constantdisqualification in this type of family (Haley, 1981). 4.4.13 Trance Induction and the Issue of Control The issue of control and power becamecentralto Haley's ideas. He first explored them in relation to the process of hypnotic trance induction where he regarded the hypnotic relationship as formally similar to that between the motherand her schizophrenic child witha struggle overwho isto govern whatsortof relationship there will be (Haley, 1981). In describing the hypnotic relationship, Haley developed the idea that all behaviour exchanged between two people defines what type of relationship they have. He classified relationships into two types, symmmetrical or complementary, based on terminology used byBateson in"Naven", (1958). (These terms will be discussed in more detail below.) This emphasis on control became a major area of disagreement on the project with Bateson objecting strongly to the use of the concept of control. However, for Haley, an approach in termsof control provided the necessary relationship context forthe double bind (Haley, 1981). 4.4.14 Summary: Implications of the Double Bind Project for Psychotherapy The research culminated in the development of a communications description of psychotherapy which included morethan justthe patientand offered a new explanation ofthe causeoftherapeutic changewiththe suggestion that paradox isinherentinvarious methods oftreatment The process of therapywasdescribed asthe working out of rules of relationship and the waystherapists preventthe patientfrom imposing his rules were described. The essential paradox faced by the patient in all methods of therapy was proposed to be as follows: "...he is benevolently helped to recover from a problem by beingencouraged to continue with it in a settingwhere he must undergo an ordeal as longas he continues with the problem" (Haley, 1981, pA7).A major contribution of this research was the enlargement of the description of therapy to include the therapist as wellas the patient The projectfinally terminated in 1962. In summarizing the aimsof the project, Haley (1981) statesthat it attempted to bring the communication point of view, the concept of levels, and theoretical concepts from related disciplines into the areas of metaphor, humour, schizophrenia, hypnosis, family systems and psychotherapy in the hope of -31- Family Therapy: Strategic and Ecosystemic Approaches achieving rigorous description of these important areas in human life. However, the difficulty came with the absence of adequate analogies to deal with the multilevel patterns in human communication systems (Haley, 1981, p.52-53). In the subsequent discussion of Haley's ideas, the centrality of the-views he developed while working on the double bind project will become evident. 4.5 Assumptions Informing Haley's Work 4.5.1 Introduction In Strategies ofPsychotherapy Haley (1963) describes the larger framework informing his ideas as an interpersonal theory where relationships are described in terms of patterns of communication in a theory of circular systems. In hislater work he outlines thedevelopmentof hisown thinking regarding psychopathol ogfand therapywithin thecontextof changing ideas in thefield of psychotherapy (Haley, 1980). Inthe 1940'sthe"mad"individual was thoughtto suffer from confused thought processes which caused him to communicate strangely and to establish deviant relationships. Therapy proceeded on the assumption that if the patient's disordered thoughts and misperceptions of realitywere corrected, he would communicate differently and relate better. In the 1950's families of disturbed individuals were observed and the observation was made thatintimate relatives communicated in deviant ways. Thus disturbed behaviour was attributed to living in a communication system where such behaviour was ap propriate. Therapy focused on changing the communication system by educative and other interventions. .In the 1960's the realization came that people communicated in deviant ways if they were organized in a way that required such communication. The disordered thought process was a product of disordered communication produced by a malfunctioning organization in which hierarchies were confused. The therapeutic task now became to reorganize the structure of the organization so that the hierarchy was corrected and so change the communication system and simultaneously the thought processes of the "mad' family member (Haley, 1980, pp.20-21). 4.5.2 Criteria for a Theory of Therapy -:::=:::. While he does not explicitly specify the assumptions underlying his theory, in Leaving Home Haley (1980), outlines the criteria which he believes determine the usefulness of a theory of therapy. These are- 1 The theory should lead to a successful outcome for therapy. It should lead to results superior to no therapy at all and it should not lead a therapist to acts which cause people harm. -32- Family Therapy: Strategic and Ecosysfemic Approaches 2 The theory should be simple enough for the average therapist to understand. 3 The theory should be reasonably comprehensive, preparing a therapist for most eventualitities. 4 The theory should guide a therapist to action rather than to reflection. It should suggest what to do. 5 The theory should generate hope in the therapist, client, and family, allowing everyone to anticipate recovery and normality. 6 The theory should define failure and explain why a failure occurred when it did (Haley, 1980, p.9-10). 4.5.3 Ideas which Handicap Therapists Haley also discussesthose theories which do not meetthese criteria and which he rejects, in a chapter entitled "Ideas that havehandicapped therapists" (Haley, 1980). He rejects the medical model or what he terms "Organic" theory which postulates a genetic or physiological basis for mental "illness". The consequences of this view have been custodial care and over-medication of individualswith problems, with littlesuccess in treatment and an absence of hope of a "cure". Psychodynamic theory, which is based on the notion that the psyche of the individual isthe problem and thatthe disturbed individual behaves as he does due tothe repression of past ideas and unchangeable experiences outside of awareness, is also rejected by Haley as a handicapping idea, primarily because of its focus on the pastand its failure to include the social context of the individual. Haley also views the double bind theory as limitingin that it encouraged a description of the family in terms of a victim of the bind. Given his emphasis on the importance of hierarchy, for the therapist to side with a ''victim'' low in the hierarchy against someone .highermay intensify rather than relieve family distress. Finally,_tl~ley.also-Iejects certainasp~_qf~~ms theo!Y.Q.nJbe.J2,~i~ isa theory o..!-sta~t of.change. It handicaps the therapist by leading him to believe that an attempt to intervene in the family activates resistance, because of governing processes which keep the family unchanged. The idea that change in one partof a system had as an effect a response in another part,~.ated.the-mythof.symptomsubstitution which made therapists reluctant to take a~()n JobJ!!!g.a.~ut change. ~, --- .. ------,...... __...... ,...... -, ..•. -•.,-. Systemstheory as it was applied to families tended to describe all members as equals so that difficulties arose when planning the restructuring of the family as Haley does, in terms of hierarchy. Systems theory also removes individual responsibility, according to Haley, with the idea that each person is driven to behave as he does because of what someone else does. . Thus while Haley advocates systems theory, regarding itschiefmerits as allowing people to be viewed not as separate indlYi~ual~.~UL~ anongoing gro~pjr:!. interaction and pe,:-,!!itting-the-therapist torecognise .repeating sequences"arid make predictions, he _.~--- ,... -33- Family Therapy: Strategic and Ecosystemic Approaches ', emphasizes the issues of homeostasis and stability and focuses on the aspects ofchange (Haley, 1980, pp. 10-25). 4.5.4 PUNYer Another uniqueaspectof Haley's approach is his emphasis on power: '7he most obvious themebetween...two men centres on who is in charge. Whetherthe question isphrased interms ofwho isG-dorwho isthe boss, the apparent issueiswhich man is to govern the behaviour of the other and so set the conditions for what sort of relationship they willhave together' (Haley, 1973, cited inJones, 1980, p.98). Since Haley views the issue of who isin chargeas central to any relationship, itfollows that itisalsoa central issue inthe therapeuticrelationship betweentherapistand client. In this regard the influence of Milton Erickson is important Haley's "strategic" therapy emphasizes-thenecessity'for.jhe therapist to be in charge of the relationship. To be successful, the therapist mustbe incontrol. A maiou.¥~~egy_O[thel~P-Y..lJ_IJ~refore. cons~ts. ..QLdirectiv~ by.J!L~Jherapi~ttoJhe .<;HentHaley thus vi~~~_the tb~~a~l!~~ syste~ag he does any other system - as hierarchical with the therapist in control (lones, 1980) . ~ 4.5.5 Organization and Hierarchy Closely related to the assumption of control in relationships isthat of organization and hierarchy. For Haley, people who have a history and future togetherfollow organized ways of behaving with one another. Indeed, all creatures capable of learning are compelled to organize. This implies that they follow patterned, redundant ways of behavingand exist ina hierarchy. ForHaley, the existence ofsucha hierarchy isinevitable since it isin the natureof organizations that they are hierarchical (Haley, 1976). While groups may have various hierarchies that assume different functions, there is always inequality, status and precedence. The repeated messages that are interchanged within organizations are messages that define hierarchical positions and such hierarchies develop over time even in groups whichattempt to organize on the basis of equal statusamong members. The hierarchy within an organization ismaintained byallthe participants. When the order isdisturbed the whole groupwill act to re-establish the hierarchy. Haley does acknowledge that the concept of hierarchy constitutes a descriptive scheme that ischosen in accordancewith the purpose of making the description and does not necessarily constitute the "truth" about the natureof organizations. There are alternative ways to describe these. However, for Haleythe concept of hierarchy, or levels of status and powerismostappropriateasa description forthe purposeoftherapy(Haley, 1976). Within the family hierarchical lines are drawn in relation to the different functions of a family. This may occur alonggenerational lines with the parents having greater power JX The issue of power and control.speclflcally as it relates to the debate between strategic and ecosystemic therapists will be discussed in detail in Chapter six. -34- Family Therapy: Strategic and Ecosysfemic Approaches and status than the children. (Thismay vary across cultures). Eachfamily has to negotiate rules regarding who is primary in status and power. 4.5.6 Sequences of Behaviour Haley continues to propose that structures are composed of repeated sequences of behaviour among people. It is in the ways that these repetitive sequences define hierarchies that Haley relates systems theory to the concept of hierarchy. The hierarchy is shaped by the behaviour of members of a system. Since such behaviour tends to be repetitive and redundant, the system isa governed one that iserror activated so that any deviancewhich defines a different hierarchyactivates a governing process wherebyother members of the system react and shape the behaviour back into the habitual pattern (Haley, 1976). 4.6 Theoretical Concepts The development of Haley's work and the concepts central to his theory of psycho therapeutic change will be presented in the following section. 4.6.1 Introduction In Haley's early work, the process of therapy and the nature of psychotherapeutic change are described in terms of levels of communication and the therapeutic paradoxes generated by confusion of these levels (Haley, 1963). This work represented a shift from the individual to a dyadic point of view. In his later work Haley not only moves from an emphasis on process to one on form as noted by Hoffman (1981), but to a more expanded view in which the unit of research and therapy is at least a triad. He also includes the larger social context of human problems so thatsymptomatology reflects patterns of behaviour in larger social organiza tions which include the therapist and the professional world in which the problem appears as well as the larger society (Haley, 1976). 4.6.2 Behaviour in an Interpersonal Context: Defining Relationships Haley rejects the inferential descriptions of conventional psychiatric theories in favour ofa description of behaviour within an interpersonal context. Individuals in interaction with others define their relationship together. They work out what communicative behaviour is to take place in their relationship by deciding what kinds of messages shall be included and which excluded in their mutual definition of the relationship (Haley, 1963). The definition of the relationship isdynamic, that is, it is not fixed, but constantly in process as new kindsof messages are included or changes in the environment provoke changes in behaviour. . -35- Family Therapy: Strategic and Ecosystemic Approaches 4.6.3 Levels of Communication However, humancommunication takesplaceat morethan one level, so that, individuals involved in defining a relationship not only communicate, but they also communicate about that communication. In otherwords,theyqualify whatthey say.Suchqualification takes place in different ways, by the context in which messages take place, by verbal messages, byvocal and linguistic patterns and bybodily movements. Haleystresses that one cannotfail to qualify a message. When a message isqualified ina congruentmanner so that the qualification affirms the message, then communication is clear and the relationship clearly defined, however, difficulties arise in interpersonal relationships when messages are qualified incongruently, negating the original message. 4.6.4 Interpersonal Maneuvres and Control in Relationships ForHaley, when a person communicates a message to another he "maneuvers" to define the relationship. The recipient may either accept the other person's definition of the relationship or rejectitand counterwitha maneuver of hisownto definethe relationship differently. Athird option is a qualified acceptance of the maneuver indicating that he is letting the other person get away with the maneuver. Maneuvers are thus messages which place relationships in question and are particularly characteristic of unstable relationships where participants are striving to establish a common definition of their relationship. Whoevercontrols what isto take placeinthe relationship, controls the definition of that relationship. ForHaley it isinherent in the nature of human communication for people to be involved insuchstruggles overthe definition of relationships. Justas it isimpossible to avoid qualifying a message, so it is impossible to avoid defining or taking control of the definition of a relationship. This isso since all messages consist of a reportaswellas a command aspectwhich influences the behaviour of the recipient (Haley, 1963). 4.6.5 Types of Relationship Haley distinguishes at leastthree different types of relationship- 1 A symmetrical relationship exists when two people exchange the same type of behaviour and thus emphasizetheir symmetry with each other. Forexample, each person will initiate action or criticize the other in a competitive manner. 2 A complementary relationship exists when two people in a relationship exchange different types of behaviour, so that their behaviour complements or fits together. One would, for example, be in a dominant position and the other in a more submissive position as with a leader and follower type of relationship. 3 Ametacomplementary relationship exists when one person letsor forces another to define a relationship in a certain way, and is thus at a higher level defining the relationship ascomplementary. ForexampleifAbehaveshelplessly and so provokes Bto take care of him, B isactually doing what he istold and so A is in a superior position. The person who establishes a metacomplementary relationship with another is controlling the maneuvers of the other and thus controlling how the relationship isdefined (Haley, 1963, pp.11-12). -36- Family Therapy: Strategic and Ecosysfemic Approaches Haley emphasizes that no two people will consistently have one type of relationship in all circumstances as relationships shift in nature constantly, for example when a child grows up he progressively shifts from a complementary relationship with his parents toward one which is more symmetrical as he becomes an adult. 4.6.6 Digital and AnalogicCommunication In Problem Solving Therapy (1976), Haley elaborates on this earlier view of human communication. Here he proposes that humans are capable of communicating in two different styles or modes, namely digital and analogic communication. Digital communication represents a logicaland precise mannerof communication where each statement has a specific referent and only that referent, that is,each message refers to only one thing. As Haley points out, such communication is only useful when describing human behaviour in relation to the environment, but becomes problematic when applied to the interaction between people (Haley, 1976). Here the language of metaphor or analogic communication becomes more appropriate. In analogic com munication each message has multiple referents and deals with the resemblances of one thing to another. It is a language in which each message refers to a context of other messages. For example, each statement that an individual makes, refers to his previous statements, to his context of interpersonal relationships and to the current relationship in which the statement occurs. The difference or change between the two styles of communication is a discontinuous one. 4.6.7 Nature of Dysfunction As the emphasis in Haley's work shiftsfrom dyadic relationships to multiple relationships in an hierarchical organization, his view of symptom formation and psychopathology reflects a parallel shift. However, even in his early work Haley stresses the link between psychopathology and the broader social context. For him psychiatric symptoms cannot be isolated from the general problems of society. "The ills ofthe individual arenot really separable from theills ofthesocial context he creates andinhabits, andone cannot with goodconscience pullout the individual from hiscultural milieu andlabel him as sickor well, " (Haley, 1963, p.2). In hisearlywork Haley argues thatthe problem of defining a relationship and the struggle for control of that relationship are universal phenomena, however when an individual attempts to gain control of a relationship, but denies that he is doing so, such behaviour is symptomatic. Here Haley defines psychopathology as "...a particular species of methods ofgaining control of a relationship" (Haley, 1963, p.13). For Haley two types of phenomena must be present for a psychiatric symptom to exist- 1 the patient's behaviour must be extreme in its influence on someone else, and 2 he must indicate in some way that he cannot help behaving as he does. Incommunication terminology, symptomatic behaviour may be seen as an incongruence between one level of message and a metacommunicative level. The person does something extreme, or avoids doing something, but indicates that he is not doing it because he cannot help himself. Thus symptoms represent some type of extreme -37- Family Therapy: Strategic and Ecosystemic Approaches behaviour which isqualified with an indication that the person cannot help it (Haley, 1963). 4.6.7.1 Paradox The communicative sequencewhichdevelopswhen a persongives conflicting directives isdescribed by Haley as paradox. Forexample, a wife requires her husbandto be home everyevening becauseshe has anxietyattackswhen she isalone. He cannot acknow ledge that she is controlling his behaviour since her behaviour is involuntary. At the same time he cannot refuse to let her control his behaviour for the same reason. The response of the receiver of such conflicting directives may be of differenttypes, he may terminate the relationship; he may comment on the impossible situation in which he finds himself; or he may respond by indicating that he is not responding to the other person.Inother words, he mayrespondwith paradoxical communication. In this way a paradoxical relationship isestablished (Haley, 1963, p.18). 4.6.7.2 Symptomatic Behaviourand Interpersonal Control Symptomatic behaviour is maintained by the individual's own behaviouras well as by the influence of significant others. By means of his symptoms the individual gains the advantage of making his social world more predictable. In particular, despite the subjective distress it causes, the symptom has the advantagethat it gives the individual control of what isto happen in a relationship with another. 4.6.7.3 Symptoms in social organizations In his laterwork, Haley (1976) extends his concept of symptoms as incongruences in communication, which are adaptive to interpersonal contexts, to larger organizations. He describes a symptom as the label or "crystallization" of a sequence of behaviour in a social organization, and pathology as the rigid, repetitive sequence of a narrowrangeof behaviour (Haley, 1976). A symptom such as depression or phobia, for example, becomes a contract between people in a social organization and istherefore, adaptive to or functional within relationships. In terms of organization and hierarchy, pathological behaviour appears when the sequence simultaneously defines two oppositehierarchies. This occurswhen a paradoxi cal message iscommunicated. Forexample, ifa persondirects another to disobey, he is defining the hierarchy in two incompatible ways. The person directed is lower in the hierarchy since he isbeingtoldwhat to do, but he isalsoequal or higherinthe hierarchy since he is beingexpected to disobeyor to behavespontaneously(Haley, 1976, p.124). Alternatively, when an individual showssymptoms, this reflects an organization that has a confused hierarchy. This mayoccur because of an ambiguous assignment of positions in the hierarchy or becausea member at one level of the hierarchy consistently forms a coalition againsta peer with a member at another level and so violates the.basic rules of organization. The confusion of status positions in a hierarchy has as itsconsequence a power struggle which represents an effort to clarify the positions in the hierarchy of the organization. -38- Family Therapy: Strategic and Ecosystemic Approaches 4.6.7.4 Coalitions For Haley it is a fundamental rule of social organization that problems arise when coalitions occur across levelsof a hierarchy. He defines a coalition as "...a process ofjoint action against a third person" (Haley, 1976, p.l09). This is especially so when the coalitions are secret and when sequences of this nature occur repeatedly, resulting in subjective distress for the participants (Haley, 1976). Haley proposes two and three generation conflict models as ways of characterizing coalitions in a malfunctioning organization- 1 In the two generation conflict model, typically there is an intense involvement of one adult and child that regularly includes and excludes another adult, for example where one parent sides with a child against the other parent 2 The three generation conflict involves three people of different generations, where the member of one generation repeatedly forms a coalition across generations. For example, where a grandmother repeatedly sides with her grandchild against the mother. The problem becomes most severe when the coalition is denied or concealed (Haley, 1976). 4.6.7.5 Summary The development of Haley's views with regard to symptomatic behaviour may be seen as follows- In his early work Haley views symptoms as incongruences in communication which serve as a means of interpersonal control in dyadic relationships. When he begins looking at relationships of more than two people, he extends this view to include sequences of behaviour between several people. While incongruences in com munication continue to be emphasized as producing pathological behaviour, Haley moves to a view of communication within a larger context, where messages that are exchanged between members of an organization define hierarchical positions. The issueof control isde-emphasized in favour of looking at the function of symptomatic behaviour within relationships. However, with the focus on coalitions and confusion in hierarchies, Haley begins to move to the more exclusive emphasis on structure which characterizes his later work. A general statement of Haley's view of the nature of dysfunction which encompasses this development is expressed in the statement that "...symptoms [are] communicative actsthat havea function within an interpersonal network' (Haley, 1976, p.99). 4.6.7.6 The Functional Family While Haley concentrates on dysfunctional communication sequences in families, he does not exclude "norma!' or functional family developmental patterns. In Uncommon Therapy (Haley, 1973), considerable attention isdevoted to the normal family lifecycle. According to Haley, families undergo a developmental process over time. When this process is disrupted, psychiatric symptoms appear. The developmental process is char acterized bytransitional points which are potentially critical, such as the birth of a first child, children leavinghome, the death of a spouse, etc. Most families pass through these -39- Family Therapy: strategic and Ecosystemic Approaches without undue difficulty. However, dysfunctional families may be identified by their inability to adjust to such transitions (Stanton, 1981). 4.6.8 Nature and Process of Therapy Given Haley's view of dysfunction as communicative behaviour which is functional within an interpersonal context, itfollows that therapyinvolves an intervention intothe communicative system of the individual. Interventions are directed at effecting changes inthe social contextofthe individual which leads to corresponding changes in his or her communicative behaviour (Haley, 1976). For Haley an individual's symptoms are perpetuated bythe way he behaves and bythe influence ofsignificant othersinhis environment Psychotherapy involves persuading the individual and/or his intimates to change their behaviour. The therapist attempts to prevent the use of symptomatic methods of dealing with people and encourages alternative methods (Haley, 1963). In organizational terms, therapeutic change involves changing the sequences of be haviour by intervening in such a way that they cannot continue. When the rigid sequences of behaviour involve malfunctioning hierarchies, altering the sequence also involves clarification of the hierarchy. For example, by preventing coalitions across generational lines, a repetitive, rigid sequenceischangedintoa system ofgreaterdiversity (Haley, 1976). Therapeutic change occurs in organizations when a therapist joins an ongoing system and changes it by the ways he participates within it He changes rigid sequences of behaviour byshifting the ways people respond to each other becauseof the ways they must respond to the therapist This is achieved by the therapist temporarily joining in different coalitions (Haley, 1976). 4.6.8.1 Control in Therapy The idea of control in social relationships is central to Haley's view of the nature of therapy, particularly with regard to his earlywork. He describes the initial encounter between therapist and client in termsof a struggle for control of the relationship. For Haley the interchange between therapist and client inevitably centers upon who is to set the rules for the relationship. While he acknowledges the relevance of such factors as support, encouragement of self-expression as well as education for the process of therapy, the successful resolution of the question of who isto have control of the kind of relationship that will exist between clientand therapist, iscentralto therapyand in it lies the sourceoftherapeutic change.Also indescribing organizations, Haley emphasizes the inevitability of dealing withthe issue of hierarchical position in relation to the other person. (The implication here beingthat the individual ina superiorhierarchical position has control in the relationship) (Haley, 1976). In light of the above, the techniques of therapyto a large extent consist of "tactics" which the therapist usesto gain control of the relationship (Haley, 1963, p.19). . . 4.6.8.2 Therapeutic Paradoxes \"ForHaley, the process 'ofall methods of psychotherapy involves therapeutic paradoxes which appear between therapist and client and which are responsible for therapeutic -40- Family Therapy: Strategic and Ecosystemic Approaches ~hange. The paradoxical situation represented by psychotherapy involves the follow Ing-- The therapist a) sets up a benevolent framework defined as one in which change is to take place; b) he permitsor encourages theclient to continuewith u-nchangedbehaviour, and c) he provides an ordeal which will continue as long as the client continues with unchanged behaviour (Haley, 1963, p.181). According to Haley, all forms of psychotherapy have In common the following paradoxes- 1 Psychotherapy is generally termed a voluntary relationship with the client seeking help of his own free will. However, within this voluntary framework the therapist indicates that the relationship is compulsory by insisting that the client keep appointments and defines any attempts to terminate therapy as resistance to change. From the client's point of view, he is posed a paradoxical definition of the relationship: it is compulsory within a voluntary framework. 2 The therapist defines the relationship as intimate, encouraging the patient to reveal all, yet the interest and concern of the therapist appears within a framework of a lack of sharing any other aspect of social life together. 3 In therapy the therapist treats the patient as if he cannot help behaving as he does, yet the framework of psychotherapy is based upon the premise that the patient can help behaving as he does since that is why he isthere for treatment 4 When a patient enters therapy, he wishes to place himself in the hands of an expert whocan and willhelp him. The therapist assumes the posture of an expertand within that framework he refrains from giving expert advice and places the initiative for what is to happen in the hands of the patient - thus resulting in a paradoxical situation where his behaviour iscircumscribed by someonewho is indicating that he is not circumscribing it 5 The basic framework of psychotherapy is benevolent Within this framework the patient undergoes a punishing ordeal which varies with the type of therapy - from a specific ordeal as in directive therapy to simply the exposing of sensitive areas of the patient's life to an unresponsive therapist - and which will continue until the patient changes (Haley, 1963, pp.183-187). 4.6.8.3 Therapy as Ordeal In Ordeal Therapy (Haley 1984), Haley elaborates on the technique of prescribing an ordeal. The effectiveness of the technique is based on the premise that if it is more difficult for the client to have a symptom than to give it up, the client will give up the symptom (Haley, 1984). For Haley the ordeal does not simply change minor behaviour, but can produce basic "character' changes. In this work Haley proposes that ordeal therapy isnot merely a technique of psychotherapy, but a theory of change that may be applied to a variety of supposedly different therapeutic techniques. He proposes that not only do all therapies implicitly or explicitly involve an ordeal, but that an ordeal is basic to any change includingreligiousconversion, as well as social and politicalchange (Haley, 1984). -41- Family Therapy: Strategic and Ecosysfemic Approaches 4.6.9 The Nature of Change For Haley the cause of therapeutic change lies in the paradoxical strategies within the therapeutic relationship. He admits that while it is possible to describe the context of therapeuticchange,its precise nature remains obscure. Haleypresumes that shifts inthe patient's relationships induce a shift in the way he or she classifies messages. He also speculates that the natureoftherapeuticchangecentersinthe unstablemannerinwhich hierarchies are defined in the therapeutic relationship, either inthat theyare ambiguous and confused, or are definedinshifting and incompatible ways (Haley, 1976). Evidence of changeappearswhen a patient becomes more flexible in his interpersonal strategies (Haley, 1963). For Haley, the mostthat can be said is that change appears to be discontinuous and occurs in stages. A system does not proceed from beingdysfunctional to functional in one step. Itisfirst necessary to createwhat Haley termsa "different form ofabnormalitY' (Haley, 1976, p.121 ).Inotherwords, the problem isredefined as another problem before it isresolved. For example, in a family with a so-called "parental child', it is possible first to make the mother overly central and so free the parental child of his or her adult responsibilities. From this new abnormal hierarchy it is possible to proceed to a more normal one. 4.6.9.1 Resistance Haley views resistance to changeas the productofthe network of ongoing relationships in which the patient isembedded, including the relationship with the therapist (Haley, 1963). For Haley relationships are formed, perpetuated, and change according to laws which are beyond the control of the individual. Here he proposes his "first law of relationships" which states that: "When one person indicates a change in relation to another, the otherwill act upon the first so as to diminish andmodify that change" (Haley, 1963, p.189). Theconsequences ofthislawfortherapyare that an attempt bya member of a system to change, will provoke other members to act to diminish that change and reinforce the statusquo. On the basis of this lawHaleyproposes the rationale forthe paradoxical strategies which 'are the techniques of histherapy. He proposes that basedon the above assumption, the therapistshould avoid requesting change directly. In thisway he sets up a paradoxical situation where in a framework designed to bring about change, he does not ask for change. A technique derived from this principle is that of encouraging the symptom. When this isdone and the patientacts so as to diminish the change requested, he will be moving toward change (Haley, 1963). -42- Familytherapy: strategic and Ecosystemic Approaches 4.7 Methodology 4.7.1 Introduction Haley's therapeutic techniques are largely based on the work of Milton Erickson. Therapy is typically brief, lasting from one to twenty sessions and is concerned with clearly defined symptoms and specific limited goals. Haley is concerned with solving a client's presenting problem within the framework of the larger social context of the problem. It is the task of the therapist to clearly formulate the problem and design an intervention, which is directed at the client's social situation, in order to change the presenting symptom. The therapist attempts to induce change from the moment of his firstcontact with a client and begins to establish a context of therapeutic change. Haley stresses the importance of the firstinterview. He sees this as crucial to a successful therapy outcome. In the initial interview, information gathering is combined with maneuvers to point the client inthedirection of change. The information soughtconcerns the present circumstances of the client as well as the current functions of his symptoms within wider social relationships. In order to overcome resistance to revealing informa tion, the therapist typicallytells the client to withhold information. For Haley it is also important to establish the client's commitmentto change early in therapy and to get him or her to accept the premise that change can occur. Haley delineates a number of stages which occur in the interview- 1 A social stage in which the therapist greets all family members. Here it is important to define the situation as one in which everyone is involved and important. In addition, it is an opportunity for the therapist to make observations and obtain information regarding parent-child relationships as well as the family organization. 2 The problem stage in which the therapist enquires about the presenting problem. A clear formulation of the problem in terms of family relationships is necessary so that these relationships can be changed. Haley also stresses here the necessity for the therapist to take charge of the session in order to effect change. 3 An interaction stage in which the family members are asked to talk with each other. This enables the therapist to obtain a first hand indication of family organization in terms of the sequences and patterns of behaviour which characterize it. 4 A goal-setting stage where the family is asked to specify what changes they seek. These stages enable the therapist to join the universe of the family and so bring about change from within that universe (Haley, 1976, pp.15-45). 4.7.2 Therapeutic Directives For Haley, brief therapy is inevitably directive therapy and involves persuading a client to participate in bringingaboutchange by asking him to follow specific directions, which involve him in a co-operative endeavour to change his symptomatic behaviour. The importance of involvingthe client in some action isstressed, as well as the necessity for the reasonableness and relevance of the required task for a particular client. Such -43- Family Therapy: Strategic and Ecosysfemic Approaches directives maybestraightforward or paradoxical, where they involve acceptingand even encouraging the patient'ssymptomatic behaviour, but rearranging the behaviour in a situation where change is possible (Haley, 1976). 4.7.3 Therapeutic Ordeals Ingeneral brieftherapy involves encouraging the symptom insucha way that the client cannotcontinueto useit.This usually involves the clientundergoing some kind ofordeal whenever the symptom occurs. The ordeal should be appropriate to the problem and cause distress equalto or greaterthan that caused bythe symptom. The ordeal mustbe within the person's capability and not involve something they could legitimately object to and itshould be done until the symptom isno longer present. The ordeal may be straightforward in nature, involving the client in doing more of something whichwould improve themselves such as exercise. Paradoxical ordeals may be prescribed, in which the symptomatic behaviour itself constitutes the ordeal, prescribed under certain conditions thus making it voluntary and under the control of the individual. Thetherapistreframing, interpreting behaviour of confronting the person mayin itself constitute an ordealforthe client.Finally, the ordeal mayinvolve morethan one individual and sometimes the entire family (Haley, 1984). 4.8 Summary and Conclusions Inthischapterthe basic tenetsof Haley's strategic therapywere discussed. Thesignificant influences on his work as well as the development of his thinking over time were explored. While he has published extensively, this chapter focused on those works in which his position as a strategic therapistis mostclearly stated and which reflect most clearly the developmentin histhinking. In his earlywork, Haley stresses the nature of communication and the inevitable struggle for control in interpersonal relationships. While he still considers the processes" of interpersonal communication, the position of Haley's laterwork moves to an emphasis on the structureof organizations. The focus on control is replaced by a concern with position in hierarchy although this appears to be largely a semantic difference as a superior hierarchical position inevitably isalsoa more powerful one. In general terms, while he devotes considerable attention to an exposition of his theoretical position, it is important to note that Haley remains primarily a pragmatic therapist who focuses on action- '7he first obligation ofa therapist is to change the presentingproblem offered. Ifthat is not accomplished the therapy is a ieilure: (Haley, 1976, p.129). -44- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 5 - The Ecosystemic Approach Family Therapy: Strategic and Ecosystemic Approaches 5.1 . Introduction In this chapter the ecosystemic approach to family therapy will be discussed with reference to the work of Bradford Keeney. Keeney defines "ecosystemic epistemology" as the epistemological framework repre senting cybernetics, ecology, and system theory (Keeney, 1983a, p.16). The term was first used in the field of communications by Wilden and Wilson (1976), but introduced into the field of family therapy by Keeney (1979). The term represents an attempt to integrate a number of ideas regarding ecology, cybernetics and systems theory in an epistemology which serves as a basis for therapy. The term emphasizes the contexts within which all behaviour isembedded and attempts to demonstrate thatsocial systems have certain similaritieswith ecological systems (Joubert, 1987). 5.2 Assumptions Informing Keeney's Work 5.2.1 The Influence of Gregory Bateson Ecosystemic epistemology has its foundation in the work of Gregory Bateson. After the double bind project, Bateson devoted himself to the development of an epistemology for the ecology of relationships which would encompass ideas from cybernetics, systems • theory and ecology. According to Keeney, Bateson's work represented an attempt to "...carve out an alternative way of perceiving and describing our world of experience" (Keeney, 1983a, pAS). Since Keeneydraws heavilyon thework of Gregory Bateson, it isappropriate to examine briefly the basic ideas of his epistemology. 5.2.1.1 The Individual in Ecological Context Bateson's early work with schizophrenic families was important in the development of his postulate that an individual is most appropriately and usefully viewed as part of an ecological context. In this earlier work he had expanded the domain of conventional psychiatric diagnosis to describe patterns of family communication as opposed to intrapsychic or intrapersonal phenomena. later Bateson postulated his basic rule of systems theory as a more universal statement of the relationship which encompasses all biological phenomena: "If you want to understand some phenomena or appearance, you must consider that phenomenon within the context of all completed circuits that arerelevant to ie' (Bateson, 1972, cited in Searight & Openlander, 1987, pp.53-S4). 5.2.1.2 The CommunicationalWorld Bateson emphasized non-dualistic conceptualizations of phenomena and focused on relationship and interaction in whole systemic patterns. He stressed that the observer is always part of t!le observed so that, for example,.the therapist isalways part of the context being treated, The world he describes is one of communication and excludes all materiality. It is a mental world of abstact ideas and their relations, as opposed to a Newtonian world of "entities" - of things, forces and impacts. The conceptual tools for -45- Family Therapy: strategic and Ecosysfemic Approaches knowing this communicational world should illuminate pattern and form (Keeney, 1983b, p.4S). 5.2.1.3 Structure of the Communicational World For Bateson, the communicational world is structured in terms of difference. Our experience isrepresented to ourselves and this representation communicated to others by means of language. However, the world of communication requires a restructuring of our language in order for description to reflect relationship, form and pattern rather that isolated elements or mechanisms. These representations or descriptions of our experience reflect implicit epistemologies''. Thestructure ofthecommunicational worldischaracterized bylogical typing and consists of levels of meaning, context and description. The mistyping of levels creates what Bateson (1972), termed"transcontextual mazes" or "tangles ofepistemological contradic tion" (cited inKeeney, 1983b, p.46). Thesemayresult ineithercreative experiences such as humour, poetry or art, or pathological experiences such as shizophrenia. 5.21.4 Function within the Communicational World For Bateson, the communicational world is mentally determined. Consequently, com municational eventssuch as interactions, are triggered by difference. Forexample, the invitation you did not receive in relation to the invitations your friends received is a difference which can trigger your interaction with the hostess. What crosses from the outside worldtothe brain, and across hemispheres within the brain is"news ofdifference" or a difference that makes a difference. Studies of neurophysiology and perception have demonstrated that we are only able to perceive difference. For example, onlywhen a noisy furnaceshutsoffdo we becomeaware of its noise and the contrasting absence of noise. This view of difference triggering communicational events leads to Bateson's view of cybernetic circuits as recursive chains of transformed difference, that is, a circular chain of differences whichare triggered by information or "news of difference". Bateson uses McCulloch's idea of the report and command levels of message in the context of ·cybernetic circuits. Thus information on one level, reports "news of difference", but on another level thisnewscommands a transformation so that the newsof difference may be passed on to the next part in the circuit A consequence of this recursiveness isthat information can inform or feed back itself. The redundant looping of information in a circuit, iswhat Bateson calls "ideas". Ideas are thussubsystems of mind and minds interact so that one can speakof an "ecology of minds" (Keeney, 1983b, pp.47-8). Brown (1973,cited in Keeney, 1983b) tookthisviewfurtherwiththe idea that the most fundamental act of epistemology is drawing a distinction. The communicational world functions by difference and constructs itself. The creation of communicational reality begins bydrawing a distinction from whichdescriptions ofthe universe can begenerated. Here the term is usedto refer to rules for describing, categorizing and knowing our experience (Keeney, 1983b, p.46). -46- Family Therapy: Strategic and Ecosystemlc Approaches 5.2.1.5 self-Reference The organization of wholesystems iscircular witheach part interacting with everyother part. For example, in the circular system A-B-C-A, not onlydoes each part interactwith everyother part lA with B, Bwith C, Awith Cl, but on another level the interaction of these interactions may be described. lA's interaction with B interacting with B's interaction with q At the level where the complete circuit interacts with itself, this constitutes the wholecybernetic sytem, sothat the circuit becomesself-referential. Varela thus defines a whole system as "... any domain of self-referential, mutual, reciprocal interactions" (cited in Keeney, 1983b, pA9). The cybernetics of complete systems has been termed"cybernetics ofcybernetics" (Von Foerster, 1974).Thecentralprinciple here is that in order to study whole systems one must approach their self-reference. It is concerned with placing the autonomy of the observer as centrally responsible for the properties of the observed (Keeney, 1983b). 5.2.2 Constructivism Anotherimportant assumption informing Keeney's workisthat we are activeparticipants in constructing our experience. Due to Bateson's influence constructivism has becomean integral partof family therapy (Efran, luken & luken, 1988).ForBateson, the physical worldisnotobjective and static, but is rather a cognitive construction. Bateson was influenced by the work of Whorf (1953), who presented evidencethat concepts such as matter,space, and time are not invariant butare the productofthe language system ofa particular social group. Bateson noted the link between language and thought and asserted that our communication patterns reflect our world view and together, these create our reality (Searight & Openlander, 1987). ~onstructivism hasitsroots inthe philosophy of Immanuel Kant He regardedknowledge as the "...invention ofan active organism interacting with an environment" (Efran et a/., 1988, p.28).This viewwas in contrastto that of the Empiricists as exemplified byJohn locke, who held that knowledge was the resultof the outside world"...etching a copy ,ofitself' onto the mind which was regarded a tabula rasa (ibid). In contrast Kantian philosophy assumes that mental images are the creations of the organism, or "inventions" about what isout there. George Kelly introduced the ideas of constructivism into the mental health field. He stressed that psychological theories were inventions and should not be confused with the discovery of some objective reality "out there". Watzlawick (1984) took these ideas further. Forhim, the shiftfrom objectivism to constructivism involves the awareness that any "reality" is the construction of those who believe they have discovered and investigated it The interests and activities of the scientific observercannot be separated from the observations he produces so that one cannot observe or describe without modifying and being modified by the subject of the observation or description. For constructivists it is necessary to acknowledge that we play an active role iri creating a view of the world and interpreting observations in terms of it An essential tenet of the constructivist position is that our hypotheses about the world are not directly provable. Scientific hypotheses persist because we find them useful in -47- Family Therapy: Strategic and Ecosystemic Approaches our work and becausethey have not yet been disproved. As Kelly notes, none of our constructions which are our only means of portraying reality, are perfect and none is final (cited in Efran et a/., 1988).Another important feature of constructivist thinking is that of context and meaning. For Varela (1979) everything issaid from a tradition and has meaning only within that tradition or context. Any change in context leads to an altered meaning. 5.2.2.1 Constructivism in Keeney's work A central tenet of Keeney's cybernetic epistemology is that reality is a cognitive construction. He emphasizes that there is no direct relationship between eventsoutside of ourselves and our inner experience of these events. Our perceptions and observations are only partial views of the whole. For Keeney descriptions of our experience are always connectedto somesortof internalized symbolic system (such as language). The language we useprescribes the waywe will encoun~orld throughour senses,so that there is no pure sensory experience or objective reality out there. What we encounter are "maps of maps". We experience the world by "...engaging in a dialectic between the abstract systems (we] create and the way [our] sense organs rub against the world' (Keeney, 1983a, pAS). However, for Keeney, the position of "naive solipsism", the idea that the world as we knowit isentirely constructed byourselves, isincomplete. So too is"naive realism", the ideathatthere exists a "rear' physical word outsideof usthatwe are capable of perceiving objectively. Cybernetics represents a method ofjoining both of these views in recursive connection. In an effortto resolve the duality, Keeney, refers to the "co-construction of reality" (Joubert, 1987). 5.222 Implications for Family Therapy Anincreasing numberoffamily therapists, including Keeney, haveimplemented concepts based on constructivist principles in clinical practice. The implications of a constructivist position for family therapy are that psychotherapy can no longer be considered an objective, value-free enterprise and human behaviour cannot be fully predicted or unilaterally controlled (Efran et al., 1988). Therapists who espouse a constructivist position have abandoned the idea that therapy involves diagnosing some objective condition such as "enmeshment" or "dysfunctional family rules". Instead they stress the needforawareness ofthe necessary influence ofthe therapist's subjectivity on the process of therapy. The role of the therapist is seen as that of a catalyst in a collaborative enterprise. For example, Keeney views clients and therapists as members of a par ticipatory universe in which each contributes to the construction and maintenance of the therapeutic reality (Keeney, 1983a, p.S1). 5.3 Keeney's Cybernetic Epistemology Whilethischapterisentitled"ecosystemic" approaches,itisimportantto notethat Keeney (1983a) rejects the term "ecosystemic" in favour of "cybernetic epistemology", which he feels is more appropriateas it connects family therapy to the work of major cybernetic -48- Family Therapy: Strategic and Ecosystemic Approaches thinkers suchasAshby, Bateson, Maturana, Varela andvon Foerster. However asJoubert (1987), points out, the term"ecosystemic" emphasizes important holistic and ecological implications and thus has been retained in thiswork. 5.3.1 Definition For Keeney (1983a) cybernetic epistemology delimits a way of discerning and knowing patterns that organize events. He distinguishes itfrom a Newtonian epistemology which isconcernedwith knowing material and the forces which operate on it. 5.3.2 Central Concepts In the discussion of epistemology, several ofthe theoretical conceptscentralto Keeney's cybernetic epistemology were discussed. These includethe following- 1 By meansof the distinctions we draw, we constructand at the same time are able to knowour worldof experience. 2 Thetool by means of which distinctions are imposed upon our world is language. 3 Theactivity of organizing experiencebymeansof the distinctions we drawisknown as''punctuation''. A number of other concepts are important in understanding Keeney's cybernetic epistemology- 5.3.21 Orders of Recursion Whitehead and Russell proposed a theory of "Logical Types" in terms of which phenomenawere classified according to orders of abstraction so that, for example, the distinction between a book and the pages of a book refers to two logical levels that indicate a class and its members respectively. Paradox arises when these levels are confused. Such paradoxes were forbidden in early logic. In its original form the theory ·of logical types assumes a hierarchically structured universe and a linearexplanation of phenomenawhich is inadequatefor a description of living systems (loubert, 1987). Keeney proposes an alternative term, namely "orders of recursion", which is more appropriate fora description of living systems. The term recursion refers to a process of infolding upon the self, much like the mythical snake Ouroborouswhich eats its own tail. Each time itswallows itself a different order of recursion iscreated. Whilethe snake remains the same, one can indicate a difference whenever the circle travels through itself. These orders of recursion are organized in patterns. In this way we are able to detect the patterns that organize any given system of knowing (Keeney, 1983a, p.35). -49- Family Therapy: Strategic and Ecosystemic Approaches 5.3.2.2 Double Description When two people interact, each member punctuates the process of interaction. If an observer combines these different punctuations in a sequential fashion, a pattern that connects them may be discerned and an idea of the whole relationship system will begin to emerge. Bateson termed this "double description". For Keeney double description represents an epistemological tool which allows one to generate and discern different orders of recursion (Keeney, 1983a). 5.3.23 Ordering Knowledge Proceeding on the above assumptions, Keeney (1983a) presents a scheme by means of which knowledge may be ordered, based upon recursive processes. Table: 5.1 I Orders of Epistemological Analysis I Description of Order of Recursion Classification of Form Process Categories of . Choreography (6) Descriptions of Metacontext Choreography Categories of (5) Interaction (4) Context Descriptions of Interaction Categories of (3) Action (2) Descriptions of Behaviour Simple Action \ (1) (Keeney, 1983, p.41) Keeney distinguishes between behaviour, context and metacontext as representing different levels of recursion. In addition he distinguishes between "classification of form" and "description of process". Classification of form represents an abstraction which -50- Family Therapy: Strategic and Ecosysfemic Approaches organizes each level of description, (simple action, interaction and choreography), by connecting its elements together in a meaningful way. Description of process on the other hand, refersto the unit being observed. These are generally at the level of sensory based experience. Form and process are linked, not in an hierarchichal manner, but are intertwined dialectically in a zigzag ladder.l:l - In order to move from one order of description to another within the above system, double description is necessary For example, interaction represents a fusing of the descriptions of two participants' simple action. The scheme will be discussed in a step-by-step fashion- 1 Descriptions of simple action refers to observations of silTIP1~..Eflions sus:has facial ~r~ons, t~L~oice, utte~~()rcJ~Lphr~.~!1d sentences, etc. Using the popular example of a nagginghusband- withdrawing wife scenario (Watzlawick, Beavin & Jackson, 1967)~ at tfiis-ievel the wife's silence and yawning and the husband's speech behaviour and accompanying body movements may be observed. 2 A therapist may then classify these simple actions as "nagging" and ''withdrawing''. Thisact of categorization isa way of identifyingand naming the pattern thatorganizes the observed simple action. The order of distinction involved is that of behaviour. As Joubert (1987) observes, the two-way arrow between simple action and the classification of those actions indicates the recursive nature of the process. Were the wife to punctuateherhusband'sbehaviour as "nagging", she would interpret all sensOry:'oase(J experiences as"nagging'. Observation and punctuation thus represent a cyclical interactive process. ~-'~"~'-'" • T' ~ ''!-:o-. . _ .r. ."...... "... " --. 3 The therapist may then observe that the categories of "nagging" and ''with'drawa/" alternate in a regular sequence. This constitutes description of interaction. 4 Should the pattern of interaction be described as a "complementary" relationship, a category of interaction has been named. J!lese-refer-to-patterns·that-characterize ~p-.of t1:!ELdifferent-participant:s~~gj()Jls. Here interaction rather than SImpleaction isthe unit of analysis which moves us to the next order of recursion ~".. 5 These contexts are themselves subject to higher order organization. "Metacontexts" refers to ~teractions..are patterned-as-parts-of..a.whole..system of choreography. =0 Descripti choreography specify how the previously identified interactional patterns are themselv_~.pattemed-orsequenced. In theexample, thecomplementary interaction of the couple may~ ~tter-"ed. For example, over time the wife may begin naggingand the husband withdrawing, while later still the pattern returns to 'the original position. 6 Were such a pattern of interaction to be observed and named, the naming would represent a category of choreography. Keeney (1983a) suggests that perhaps the The term·dialectic" as used byHegel, refers to the •...supposedreaction bywhicheveryconcept necessarily develops its opposite· Ooubert, 1987, p.l4). -51- Family Therapy: Strategic and Ecosysfemic Approaches concept "double-bind l may refer to such a category of choreographed interaction. However, there is a lack of appropriate language withwhich to describe such classes of choreography (Keeney, 1983, ppAO-44). 5.4 Cybernetics Keeney defines cybernetics as "...part of a general science of pattern and organization" (Keeney, 1983a, p.6). The term was first coined by Wiener (1948) who traced its etymological roots to the Greek where itwas used to signify both the art of steering and of command. As Keeney (1983a) points out, since the word refers to both nautical and social control, itsuggeststhat cybernetics is concerned withsocial as well as mechanical systems. 5.4.1 Simple Cybernetics A central concept in C):'bernetig iSJ:h..~J_QC'ieedbacK:. Wiener defines feedback as "...a method of controlling stem b reinsertin into it the results....oijts..past.~rmance" (cited in Keeney, 1983a, p.66 . the informationfeg~ts performance lSa6Te to change that performance, then the process may be termed learning. An example of feedback isthethermostatically controlled heating system which is self-corrective, so that when fluctuating temperature exceeds the boundaries of the calibrated thermostat, the furnace is activated to turn on or offand so bring the temperature back within the desired range. 5.4.1.1 Negative and Positive Feedback "Negative ieedbsck" is said to be in operation when feedback opposes the direction of the change which produced the feedback, as is the case with the thermostat which regulates the temperature of a house and so maintains itwithin a desired range. Positive feedback, on the other hand,~i~rs.to information .. which_~mplifies change in the direction in which it is already changing. For example, this would be the case with a lJtfrSOn who is encouraged-to oecome-more aggressive by the consequences of his prior aggressive behaviour (loubert, 1987). Negative feedback is traditionally associated with stability and positive feedback with change. Keeney prefers to speak only of negative feedback and in this way avoids any dualism between the two concepts. He argues that what sometimes appears to be positive feedback is part of a higher order or more encompassing negative feedback process (Keeney, 1983a). 5.4.1.2 Stability and Change The ~~·~~~~:?!~i~:jLQften....usedJ~c:!~Jibe-pr~~_QL<;h~lJg~..~~ich lead to sta§ll!>'. N~tiVe ana positive feedback represent such processes. However, as Keeney ~a~ points out, o/~.!1~c;.pJocess~r achieves a static, steady state. Corrective action IS brought about by difference. The difference between a present state and a preferred state activates the corrective response (Bateson, 1972, cited in Keeney, 1983, p.69). Thus stability and change must be viewedtogether as complementary sides of the -52- Family Therapy: Strategic and Ecosystemic Approaches same process so that all change can be seen as an attempt to maintain stability and all stability as regulated bychange (Joubert, 1987). 5.4.1.3 Higher Order Feedback There are different orders of feedback control which are recursively connected and which account for stability and chang~heJ:-Qrd~Lf~9.aclLrefers_to",a..process wherebyinformation regarding a whole patl,:~rn.q(~h~'(i8~~ted back(Joubert, 1987). ~For exampte, a motonsfremains within the speed limit as he is regulated by a traffic officer, who in turn is regulated by a chief traffic officer, the chief traffic officer by the state and the state byvoters who include the motorist (Bateson, 1979, cited in Keeney, 1983a). Feedback which is not subjectto higher order control will lead to unchecked escalation which ultimately destroys a system. Changein the direction of learning or adaptation also arises from higher order control. Forexample, ina family witha psychotic adolescentwhose behaviour escalates towards being unmanageable by the parents, a higher order of control is triggered when they seek a therapist who institutionalizes the adolescent. However, thisfeedback involving the institution maintains the family organization in such a way that the adolescent's successful disengagement from the family isblocked. In orderto effectchangea therapist wouldhaveto establish an alternative orderoffeedbackwhichwouldchangethe pattern which recursively connects the family, therapist and the institution (Haley, 1973, cited in Keeney, 1983a). 5.5 Cybernetics of Cybernetics Simple cybernetics isrestricted to an examination of the relation of input to output in a system in an effort to detect redundancies (rules). It is referred to as "cybernetic" when the output isseen to be acting on thejnpUl~.as~() rllO(jify futureoutput.Thelimitation of this app~cb..isjts-fairure.tojncludetbe_observeLil1 tbe"p.heJl()I1l~~ The P~!~'~9'~m~tlg~Qt<;)'berneti~was-originally pu~~arc! by ~~!~r~,tM"ead as a"means of indicatin the observer's inclusion and rtici~~g!Li[lthe system. Cyber netics 0 cybernetics does not exc u e simpe cybernetics, but refers to a higher order of recursion than simple cybernetics. It refers to homeostasis of homeostasis, control of control and feedback offeedback. ForKeeney, whilesimple cybernetics views a system in the context of the inputs and outputs of various other systems, cybernetics of cybernetics enablesone to speakofthe autonomy ofwholesystems. Each viewprovides a different but complementary perspective (Keeney, 1983a). Cybernetics of cybernetics includes the conceptsof self-reference and autonomy- -53- FamilyTherapy: Strategic and Ecosysfemic Approaches 5.5.1 self-Reference Since cybernetics of cybernetics places the observer in that which is observed, all description is self-referential. Thusthe concept of"objectivity", which assumes a separa tion between the observer and the observed, becomes nonsensical and by implication, also that of subjectivity. For Keeney. (1983a) the question then becomes one of ethics relating to howthe observer participates inthat which he observes. Inother words, how we participate in the construction and maintenance of our experiential universe. The concern with oojectivity issubstituted by one of responsibility. 5.5.2 Autonomy Cybernetics of cybernetics isdescribed as a way of viewing the "organizational closure" or autonomyofsystems (Keeney, 1983a).Thesystem isviewedas entirelyself-referential with no reference to its outside environment The autonomy of living systems is characterized byclosed recursive organization. It involves a networkof interconnected feedback loopsthat isclosedand has no input or output from an outside environment Outside influence may interactwith the wholeness of the system by "perturbing' the stability ofthe wholesystem, which in response mayor maynot compensate. However, the system retains its autonomy(Varela, 1976 in Keeney, 1983a). Itisa system's highest order of recursion that defines, generatesand maintains the autonomyof a system. For Keeney, the concepts of autonomy implies that all living process embodies cybernetic epistemology. 5.5.3 The Family as an Autonomous System The family system, at itshighest order of recursion isan autonomoussystem. Its highest order of feedback process serves to maintain its unity as a closed social organization. Theautonomyofa family cannotchangeor itwouldcease to exist What does however, change isits structureor the way it maintains its organization. ForMaturanaand Varela (1980), organization and structureare of different logical types. Keeney proposes a metaphoric examplewhich illustrates thispoint Ifan inflated balloon 'were to be considered an autonomoussystem, the action of squeezingthe balloon may be regarded as a pertubation which alters itsshape but does not allow one inside the closed boundaries of the system as the balloon would burst Ifthe pertubations on the system are too severe, theywill be compensatedforbya changeinthe system's structure. The balloon'sability to alter its shape allows it to endure (Keeney, 1983a, p.103). 5.5.4 Dialectic of Calibration and Feedback Keeney describes the dialectic of feedback and calibration within higher orders of cybernetics in termsof a similar zigzag dialectical ladder to that used to describesimple cybernetics. Moving from simple feedback to simple calibration accounts for the organization of simple cybernetic systems. As higher orders of feedback process are reached, thissimplefeedback becomesopen to recalibration which represents the level of cybernetics of cybernetics. Thezigzag pattern reachesa limit when the highest order of calibration and feedback in a system, itsautonomy, is reached. -54- Family Therapy: Strategic and Ecosysfemic Approaches 5.5.5 Mind as a Cybernetic System Gregory Bateson defined "mind' as a cybernetic system. Thus mind is an "...aggregate of interactive parts with feedback structure" (in Keeney, 1983a, p.9~). Wherever there is feedback, mental characteristics will be evident Mind is thus not a property of single organisms, but of the relationships between them. In this way for example, the "mind' of a blind man crossinga street necessarily includes his cane which is an active part of the feedback process that guides the man. Taken to its ultimate conclusion, the concept of mind leads to the idea thatall living process becomes interconnected and one(Keeney, 1983a). 5.5.6 Cybernetic Complementarities Cybernetic epistemology aims to embrace both sides of any distinction that an observer draws. For Keeney (1983a) distinctions are not viewed as either/or dualities, which he regards as assuming an underlying logic of negation of the type Nnot A; right/wrong. Instead both sides are viewed as different, yet related. The relationship between the sides of the distinctions isself-referential, where one side is recycled out of the other. The one side represents the totality or whole, and the other the corresponding processes, constituents or dynamics. For example: stability/change; family/individual; cybernetics of cybernetics/ simple cybernetics. Such cybernetic complementarities involve different orders of recursion, so that while the pairs are related, they remain distinct For Keeney (1983a) the perspective of cybernetic complementarities transforms our ways of knowing, towards a more aesthetic .view where all mental and livingprocess is seen as recursive and complementary. 5.6 Cybernetic Family Therapy 5.6.1 Introduction In the cybernetic view, the unit of therapy is not individuals, couples, families, com munities or societies. Rather, cybernetics focuses on mental process, as defined above, where mind represents a system in interaction with a feedback structure. Cybernetic epistemology views the therapist and client, not as separate agents acting upon one another, but looks for patterns that connect both components through a feedback structure. Similarly health and pathology, symptom and cure, diagnosis and intervention are recursively connected (Keeney,1983a). 5.6.2 The Therapeutic System Given the cybernetic principle that the observer is always in the observed, for Keeney (1983a) therapists do not observe c1ien~~ther they observe their rel~~on_$hips with clients. A new cybernetic system comes into being when therapist and client meet The therapist affects the system he is"treating' and in turn, the system treated always affects thetherapist Itisnot possibleto distinguishwhatiscontributed bywhom as both therapist and client are-punctuations of a whoIe system. As part of the system the therapist is "..-. ------" -55- Family therapy: Strategic and Ecosystemic Approaches subjectto its constraints. He does not unilaterally influence or change the system, but his presencemay helpdetermine how the system isorganized. As the therapist is part of feedback, the family members will organize their behaviour around him ina particular wayand theirreaction will leadthe therapistinturntoorganize hisbehaviour aroundthemandsoon, ina continuing process. ForKeeney, to beeffective the therapist must be able to vary hisbehaviour and recognize the effects of his and the other participants 'action (Keeney, 1983a). 5.6.3 The Cybernetic View of Health and Pathology ForKeeney, the classification ofcertain actions, patterns or systems as either pathological or healthy is incompatible with cybernetic epistemology which attempts to transcend such polarities. Theterms''pathology'' and "health" are sidesofa cybernetic complemen tarity and represent punctuations made by an observer. Theydo not constitute "truth". The cybernetic principle of the obtrusiveness of the observer stresses that the therapist isalways a partof the field being observed in diagnosis (Keeney, 1979, p.122). Any attempt to classify human behaviour necessarily constitutes an attempt to reify the world.ForKeeney the traditional clinical procedureof ascribing a labelto an individual in order to signify a particular pathology, cannot be separated from an underlying epistemology of lineal causality, whichisatomistic, anticontextual and thus nonsystemic and mayhinderthe process of therapeuticchange (Keeney, 1979). Theattemptto "discover" pathology isself-verifying, according to Keeney and contributes to the creation ofthat verypathology. With the developmentof increasing categories of psychiatric diagnosis, theconstruction and discovery ofrelevant disturbances ismobilized (loubert, 1987).Thetherapeutic contextisconstructed and maintained bythe therapist's method of collecting data or diagnosing. The questions he asks together with his hypotheses helpcreate the "reality" of the problem beinginvestigated (Keeney, 1983a). 5.6.3.1 Symptoms in Cybernetic Epistemology tn the cybernetic view it is necessary to viewsymptoms within the context of recursive feedback. Given that systems achieve stability through change, pathology or symptomatology allows a stable stateto be achieved through a process of changewhich Keeney terms"escalating sameness". This refers to an escalation inintensity ofa particular emotion or some extreme behaviour. Symptoms therefore indicate a system's effort to maximize or minimize certain behaviour or experience. For example, a feeling of discouragement mayescalateintoclinical depression. Initially the escalation appearsas an escalating runaway at which point the individual is labelled "mad' or"sick'. However, thisrunaway behaviour iseventually curbed byhigher order feedback processes of the social system such as psychotherapy or institutionaliza tion. In addition "symptomatic" behaviour fits into the organization of a particular interactional context. Keeney thus defines a symptom in terms of cybernetic process. "...Symptoms represent recursive feedback cycles of escalated behaviour and experience that areorganized in a whole interactional system" (Keeney, 1983a, p.124). However cybernetic epistemology rejects the idea of merely punctuating the family rather than the individual as "sick'. It looks at how individuals and families maintain an -56- Family Therapy: Strategic and Ecosystemic Approaches organization through recursive process. Family interaction showscharacteristic patterns, which Jackson termed ''family rules". Sequences of interaction which contain symptomatic behaviour maybeseen as metaphors forallfamily sequencesof behaviour. Inthisviewsymptoms are regarded asmetaphors forawholeecology whichcharacterizes the presentstateoffamily interaction. The consequencesofthisviewforclinical practice are that the therapist can work with any sequence in a family and be working on all sequences.Inaddition, the symptom represents the form of language that the family has chosento useto talkabout their"troubled ecology". Itisthen necessary that the therapist effectively work on the whole family ecosystem through that form of language. For Keeney in this lies the "artistry" of therapy. What istermed "resistance", isexperienced when therapists do not match their language to that of the family (Keeney, 1981). 5.6.3.2 Ecological Climaxas Metaphor for -Health- ~cal climax refers to~~I~~~_e_9Lcliy~rsity.in..an.eeosystem. When the interactions ofdiverse species are nerd In balance, thisisreferred to asecological climax. ForKeeney, following Bateson thisissynonymous with health. The alternative ischaracterized bythe maximization or minimization of any variable in an ecosystem. A focus on anyone componentat the expenseofothersinan ecosystem will disrupt the balance.Inbiological systems the uncontrolled spread of flexible species(for example, weeds), breaks down the ecosystem and weeds remain. Bateson thus defines pathology as "...those things whichdestroy climax" (1974, cited in Keeney, 1983a, p.126). With reference to human ecosystems, health refers to a balance of diverse forms of experience and behaviour. An attempt to maximize or minimize one characteristic or behaviour leads to the escalating sameness which Keeney refers to as pathology. Similarly, healthy families are 'characterized by diverse interactional episodes, which provide a type of ecological climax. On the other hand, monotonous repetition of redundant interactional sequences indicates a pathological family. The creation of pathology may also be implicit in the process of therapy. For Keeney, (1983a) the focus on the developmentof healthyindividuals at the exclusion ofthe larger ecology, itself represents an attemptto maximize one variable, namely individual health. After a certain limit, health becomes unhealthy at another order of process. For ecosystemic thinkers, the healthy individual is an "...integrated, whole unity of diverse differences..."and isthus not necessarily free ofsymptoms (Keeney, 1983a, p.126). Since healthand pathology are seen assidesof a cybernetic complementarity, pathology isan approximation or partof a more encompassing whole, "health". For Keeney, the concept of ecological climax provides an "aesthetic metaphor' for discussing healthand pathology (Keeney, 1983a, p.127). 5.6.4 The Nature of Change Inecological terms, the principle exists that organisms heal themselves if not interfered with. By virtueof itsrecursive structureand self-corrective nature,anydisturbed partwill readjust if left alone. Any attempt to completely remove problems or disease will unbalance an ecological system, as it represents an effort to minimize the variable of pathology and maximize that of health. The implication for family therapy is that the focus should be on how to let the system achieve itsown adjustments. -57- Family Therapy: Strategic and Ecosysfemic Approaches 5.6.4.1 Unconscious Processes Keeney stresses thatchangeoftenoccurs inthe realm ofthe unconscious whichhe views as a reservoir of healing potential. Certain perceptual processes as well as the premises which govern essential functions suchas breathing, inorder to beeconomical, takeplace at the level ofthe "unconscious". The more basic suchfunctions, the less accessible they are to the conscious mind and the better we knowcertain rules, the less likely we are to be able to formulate them consciously. In thisway it is possible to speak a language fluently without consciousness of the rules of grammar and syntax. In the same way members of a family system "obey" higher order principles, such as cybernetics of cybernetics, withoutany conscious knowledge of what these processes entail (Joubert, 1987). Whereas conscious processes operate on the level of linearity and logic, for Keeney (1983a), the functioning ofsystems depends upon recursive and circular processes which are often not accessible to consciousness. Any conscious, logical explanation of a recursive process is necessarily always only a small part of a larger recursive arc. Thus the therapist is often not able to have a complete, conscious understanding of the cybernetic cycles whichoccur in a therapeuticsystem, and neither is he always able to formulate these interactions completely. 5.6.4.2 An Aesthetic Therapy What is required in order to transcend these difficulties, according to Keeney, is an aesthetic basis for therapy. This occurs when both conscious and unconscious mental processes provide self-corrective feedback. A merely pragmatic orientation to therapy does not take into account the ecology of the problems dealt with and this results in higher orders of pathology. In contrast, an aesthetic base for therapy requires that techniques be coupledto higher orders of unconscious mental process. It is necessary that the therapist develop respectfor ecology. This follows when a therapistviews and conducts himself as part of a more encompassing mental system. This involves an awareness that anyparticularfeeling, perception or ideaisalways a fragment ofthe larger contextthat embodies it (Keeney, 1983a). For Keeney, therapy encompasses both aesthetics and pragmatics, art and craft and is often based upon a degreeof intuition. Tbe.artistic...aspect.oftherapy_emergesjn the use of metaphor, anecdotes, paradox, rituals, dreams and.other, forms of analogue com- miiilication-which originate"fiomthe unconscious creativity of the therapist (Joubert, 1987). 5.6.5 The Process of Therapy Basic to understanding changewithin the contextof cybernetic epistemology, isthe idea that change represents halfof the larger cybernetic complementarity "stability /change" (Keeney, 1983a).Therapeutic changeof a cybernetic system involves changeof change. In other words, change of how a system's habitual process of change leads to stability. Effective therapycan thus be described as a contextthat enablesa cybernetic system to calibrate the way it changes in order to remain stable (Keeney, 1983a, p.178). -58- Family Therapy: Strategic and Ecosystemic Approaches Based on the workof Ashby, Bateson argued that change requires both a sourceof the random and a sourceof order. The source of random must havea meaningful fitwith the system and has been described as a "meaningful Rorschach", (Keeney, 1983a), or later as "meaningful noise", (Keeney & Ross, 1985). Keeney explains the latter term as follows: Meaningful noise indicates that an intervention should be meaningful to the client(and to the therapist), but it is noise in the sense that any possible meaning may be constructed out of it (Keeney, 1987, p.475). Thetherapist hasto conveymessages of change, stability as well as a relevant Rorschach to the system in hisattempt to change the general pattern of the recursive organization of stability and change. 5.6.5.1 Constructing Therapeutic Realities - semantic and Political Frames Keeney stresses thatthe process oftherapyinvolves boththe clientand therapist actively participating in the construction and maintenance of a therapeutic reality. He depicts the construction of therapeutic realities in termsof the management of ''semantics'' and ''politics'' which represent two frames of reference for viewing human communication (Keeney & Ross, 1985; Keeney &Silverstein, 1986; Keeney, 1987). A political frameof reference indicates "...the cybernetic organization ofcommunication inhuman relationship systems" (Keeney & Ross, 1985, pp.14-15). Itindicates asequential patternof behaviour of the type"who-does-what-to-whom-when". On the other hand, a semantic frame of reference contextualizes or provides a particular meaning, for an observer, to a sequence of behaviour or a political frame. Semantics refers to a communicational frame of reference wherein meanings are requested and constructed (Keeney, 1987).Keeney (1987) uses the term"semantics" to describe what he previously, (1983a; 1985),referred to as"meaningful noise" ~~'1~y,all "mapping' or.description of th~~py~involves-a-dialectic between semantic and political frames of reference. The .tWo·fral'!!~are.recursively connected. 5.6.5.2------The Process ofTherapy in terms of semantic and Political Frames The distinction between political and semanticframes of referencedescribes the basic building blocks used inthe construction oftherapeutic realities. Clients presenttherapists withsemanticand political fra~.which are then usedto construct a therapeuticreality. in order to assist a troubledsystem, the therapist must_~~~<> -59- Family Therapy: Strategic and Ecosysfemic Approaches ForKeeney (1987) therapyinvolves addressing the change and stability of semantic and political frames that are presented in therapy. He describes the structureof therapeutic interventions as follows-- Table: 5.2 The Structure of Therapeutic Interventions Prescription for stability Prescription for change 1...- Politics-----~ prescriptions given through some semantic frame of reference I'------5emanti=-u_t-----....I (Keeney, 1987, p.47S) The patternorganizing the semantic and political building blocks of a therapeutic reality directs how the therapist politically prescribes to clients what should change and what should remain stable. The waysuch prescriptions are "packaged' usually requires some rationale or explanation. This explanation is a semantic frame about the therapist's political prescription. In summary, clients recursively direct therapists in how to direct the construction of semantic and political frames (Keeney, 1987, p.476). 5.7 Summary and Conclusions Inthischapter Keeney's cybernetic epistemology wasdiscussed. The principles informing his theory as well as its central concepts were explored. It is evident that his work is strongly influenced byconstructivist principles as well as the ideasof Gregory Bateson. Central aspects of Bateson's epistemology were briefly outlined. Keeney's application and expansion of Bateson's epistemology to the field of family therapy was explored in more detail. In contrast to Haley's strategic therapy, Keeney presents a well developed and sys tematized theory of therapy. However, he devotes considerably less attention to the practical implementation of these theoretical principles and it is in this area that the limitation of cybernetic epistemology lies. Inthe following chapterthe Strategic and Ecosystemic approaches to family therapy will be compared. -60- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 6 - Comparing Strategic and Ecosystemic Approaches Family Therapy: strategic and Ecosysfemic Approaches 6.1 Introduction In this chapter the two approaches discussed above will be compared along two broad dimensions, namely- 1 Informing Epistemology 2 Methodolgy With respect to the informingepistemology, the views of each approach with regard to the nature of realitywill be examined, as well as their attitude to "science"and thus the problem of prediction. The specific conceptualization of systems theory or cybernetics each espouses, will be discussed. The problem of ''power' and the conceptualization of the nature of health and pathology will also be addressed. In addition, the issue of self-reference will be addressed here. With regard to methodology, the two approaches will be compared in terms of their preference for an aesthetic or pragmatic emphasis, as well as a focus on process or content. . In lightof what has gone before it is important to note with respect to the organization of this chapter, that the distinctions which will be drawn, represent the punctuations of this writer. In addition, the comparison of the two approaches in terms of an apparent "either/or' dichotomy is necessarily reductionistic and represents a reification of the concepts. One cannot separate the different categories, all are connected. In ecosys temic terms, such organization would be termed unaesthetic, however it is necessary for pragmatic reasons. AsKeeney, notes, "... we are free to carve the world as we like as long as our carvings are remembered to be approximations for the more encompassing patterns from which theywere demarcated' (Keeney, 1982b, p.162). 6.2 Informing Epistemology In the chapter on epistemology it was pointed out that one cannot not have an epistemology. This applies equally to therapists. Every theory of human behaviour and every attempt to change human behaviour contains an underlying theory of knowledge (Guttman, 1986). Whether or not a therapist is conscious of his epistemology, his descriptions of a problematic situation, and his methods of resolving such problems, contain an implicit epistemology (Keeney, 1979). This epistemology leads to the~ construction, maintenance, and experience of a particular world view (Keeney, 1983a, p, 15). Guttman (1986) notes that no two therapists meet the same system. Each focuses only on certain phenomena and attends only to a manageable aspect of the complex phenomenon of family. The aspects which are attended to are inevitably influenced by the therapist'spre-existing theoretical paradigm. Thus, for Bateson "...epistemology is always and inevitably personal. The point of the probe is always in the heart of the explorer' (Bateson, 1979, cited in Guttman, 1986, p.14). -61- Family Therapy: Strategic and Ecosystemic Approaches In order to compare the strategic and ecosystemic approaches to family therapy it is necessary to examine the epistemologies informing the respective theories. Keeney, as representative of the ecosystemic approach, devotes a great deal of time to exploring and making explicit his cybernetic epistemology. This is not true for Haley. Haley's pragmatic orientation excludes any lengthy discussion of theory, and he fails to makehis epistemology explicit. Such an approach is necessarily incomplete and has inherent dangers, in that it is open to misinterpretation. As Fisch, Weakland and Segal, (1982) point out, when the premises and assumptions of a theory are not made explicit, they are allthe more influential, sincetheyare less open to review, questioning, and possible revision. - 6.2.1 Assumptions InformingHaley's Work The assumptions underlying Haley's workare to be inferred to a large extent from those ideaswhichhe rejects ratherthan from an explicit exposition of hispremises. This makes it difficult to offer anysystematic viewof these assumptions. The criteria which Haley believes determine the usefulness of a theory have been discussed earlier:un summary, the usefulness or otherwise of a theory depends on its simplicity and its practical value in terms of suggesting interventions and determining successful outcomesintherapy. On the basis of these criteria, Haley rejects the ideas of~ organic theorywith the dangers inherent in labelling individuals in terms of diagnostic categories. He also rejects psychodynamic theory as well as certain aspects of systems theory, particularly the concepts of homeostasis and the systemic description of family members asequaland henceequally powerful. For Haleythismakes itdifficult inpractice to effectchanges in the ''faulty'' structureof the family (Haley, 1980). Inhis earlier workHaley described the framework informing his ideasas an interpersonal theory of patterns of communication in relationship systems (Haley, 1963). While he continues to referto his workintermsofcybernetic systems theory, hislaterworkreflects a much greater concernwith organization. Haley's organizational theorywill be summarized briefly here. Hedefines an organization asa system of repeating sequencesincommunication. Where peoplecommunicate witheach other insystematic ways, that communication becomes the organization (Haley, 1980, p.24). ForHaley, alllearning animals organizeand cannot avoid doing so. This implies that they follow patterned, redundant ways of behaving. Organizations are hierarchical, with some members having morestatusand powerthan others. Every message between people in an organization definestheir relationship as well as the person's hierarchical position in the organization. From this perspective, psychopathology becomesan expression of a malfunctioning organization. In therapy it is necessary for the therapist to actively restructure the organization. Although Haleyclaims to adhere to a "systems" theory, the developmentof his ideas in terms of organizational theory with the emphasis on structure, hierarchy and power, reflects rather, a lineal, Newtonian epistemology. The conceptsof hierarchy and power necessarily imply a paradigm of lineal causality, where one memberof an organization, having greater powerthan another, isable to exerta unidirectional, linearinfluence on another member. Following Bateson, while many therapists may claim to follow a -62- Family Therapy: Strategic and Ecosysfemic Approaches non-lineal,systemic epistemology, since they deal with whole families rather than individuals, thisalone does not necessarily reflect a non-lineal epistemology. The basic premises underlying Haley's model, particularly as reflected in the language used, indicates adherenceto a paradigm ofmaterial, forceand energy(cited inKeeney, 1983a). 6.2.2 Keeney's Cybernetic Epistemology Inthe discussion of Keeney'secosystemic or cybernetic epistemology thisapproachwas defined asthe epistemological framework representing cybernetics, ecology, andsystems theory(Keeney, 1983a).Cybernetic epistemology isdescribed asnonlineal and is attuned to relationship, complexity and context in whole systemic patterns and excludes all materiality (Keeney, 1983a). Incontrastto Haley's organizational approach, cybernetic epistemology emphasizes circular causality. Systems are defined and identifi:9 by mutual and simultaneous interactions. Keeney's cybernetic epistemology focuses on non-dualistic conceptualizations of phenomena, so that concepts such as health and pathology, change and stability, therapist and clientare viewed as recursively connected systems in interaction. For Keeney, a fundamental act ofcybernetic epistemology involves drawing distinctions. By means ofthe distinctions we draw,we constructour worldof experience. Therefore, another important assumption underlying Keeney's cybernetic epistemology isthat weK are active participants inthe construction and maintenanceof our experiential universe. This will be discussed in the following section. 6.2.3 The Nature of Reality 6.23.1 Cybernetic Epistemology and Constructivism Keeney's cybernetic epistemology implies a constructivist position with regard to the nature of reality. The drawing of distinctions and the punctuation of our experience in termsofthosedistinctions, implies thatwe allparticipate inthe construction ofour reality, including the therapeutic reality. The construction of reality is a reciprocal process: "...what one knows leads to construction and what one constructs leads to knowing' (Keeney, 1982b, p.170). Keeney emphasizes then that the world as we know it is not entirely constucted byourselves. He prefers to speakof the "co-construction ofrealitY'. ForKeeney, therapist and clientsimilarly participate inthe construction and maintenance of a therapeutic reality. Therapy isa cyberneticsystem where both therapistand client are partsof co-learning and co-evolution (Keeney, 1983a, p.133). \~->G\Q'<'b - ,--.i\lO~ ":.:. .., ~ .~\l.L y{~~W/" ,~ '1 6.23.2 Haleyand an ·Objective· View of Reality WhileHaley does notarticulate explicitly hisstancewith respectto the nature of reality, MacKinnon (1983), points out that Haleyislikely to see hispunctuations or assumptions as realor fact. \she bases thison Haley's concern with structureand organization. She quotesTomm--JthoVegards Haley as a systems theoristrooted inthe Western philosophi caltradition. He isthuslikely to regard the stableorganization ofthe elementsina system as crucial, so that the system exists by virtue of itsstructured complexity. This position contrasts withthosetherapists, forexample, the Milan schooland Keeney whose position -63- Family Therapy: S1rategic and Ecosysfemic Approaches is closer to the Eastern philosophical view. For them, systems represent an ongoing process of changing connectedness, so that the system exists by virtue of its changing complexity (Mac Kinnon, 1983). The implications of these different punctuations are that in practice, in conceptualizing families, Haley's approach is concerned with fewer elements, and he arrives at a structural hypothesis that is easily" verified and which gives immediate direction to his work. ~ sU~~~~~=likelt!~.~~ his punctuation__~_.r~presenting something real or factual (Mac Kinnon, 198:f,(J.427-8).-----·-·-- Haley's views on research which he makes explicit in Leaving Home (1980), appear to confirm thisview, as he allows for the possibility of objective description, as w~asfor an absolute"truth" (Haley, 1980, p.17). -- However, asBogdan (1988) and Efran et a/.(1988), pointout, constructivism isnottotally at variance withthe ideas that haveinformed strategic therapists, and Haley in particular is cited as an example. For Bogdan the technique of reframing is central to strategic therapy. This technique presupposes that people construct both the definitions of a situation and,what hetermsthe''personal historical narratives" thatguidetheirbehaviour (Bogdan, 1988, p.51). As Mac Kinnon (1983) points out, Haley uses reframing insofar as he may give a family a different explanation for a particular behaviour in order to create a moreworkable therapeutic reality. In addition, the pragmatic attitudeof Haley and the value placed upon utility, ''what works", as opposed to "truth" or theoretical principles, is, according to Efran et a/.(1988), a centralelement ofconstructivist thinking. Thus Haley's position withregard to the natureofreality is. inconsistent andcontradictory, primarily due to the factthat he does not clarify his premises. 6.2.4 Health and Pathology 6.24.1 The Ecosystemic View Keeney (1983a), regards an either/ordichotomy with respectto healthand pathology as incompatible with his cybernetic epistemology, whichattemptsto transcenddualisms of this nature. Rather, he views healthand pathology as sidesof a cybernetic complemen tarity, with pathology beingan approximation or part of a more encompassing whole, "health". In ecological terms, a balance of diversity in an ecosystem, (ecologcal climax), is regarded as healthy, whereas the maximization or minimization of any variable is pathological. Thus, with respect to human ecosystems, health requires a balance of diverse behaviour and experience, and pathology, the rigid repetition of a particular sequence of behaviours. The "healthy" individual isnot necessarily free of symptoms. For Keeney, the process of therapy itself may contribute to the creation of pathology since it is concerned with the development of healthy individuals and often excludes reference to the larger ecology. This represents the maximization of one variable and is, therefore, pathological, so that at a different logical level, health becomes-unhealthy (Keeney, 1983a). In keeping with a constructivist position, the concepts of health and pathology in the ecosystemic viewrepresentpunctuations ofan observerand do notconstitutethe"truth". -64- Family Therapy: Strategic and Ecosystemic Approaches The therapist's method of diagnosing creates the "reality' of the problem being inves tigated. 6.2.4.2 Haley's Strategic View Haley (1980), rejects traditional psychiatric nomenclature. His objections are concerned with the consequences of adopting the idea that there isa physiological basis for what he terms, "madness". Theseconsequences include institutionalisation, over-medication and a lack of hope forthe successful treatment of labelled individuals. While Haley rejects an organic basis for "mad' behaviour, he assumes instead a social ...... --~,/ cause for disturbed behaviour, where pathology is the consequence of conflict and confusion in organizational hierarchies. For example, he speaks of pathology as "...a product of disordered communication produced by a malfunctioning organization " (Haley, 1980, p.21). This position implies unidirectional causality and reflects an underlying lineal paradigm. In addition, while Haley discards psychiatric labels, he replaces these withother terms such as "mad', "crazy", "eccentric" and "problem" people (Haley, 1980). As Keeney points out, the practice of labelling is reductionistic and represents a reification of the world. It is necessarily tied to an epistemology of lineal causality. \ Further, thedichotomization ofthe conceptsof health and pathology isevidentinHaley's implicit distinction betweenfunctional and dysfunctional families, "mad' and therefore, by implication "normaf' behaviour. This contributes to the idea that hiswork reflects an underlying paradigm which is consistent with a Newtonian worldview. 6.2.5 SCience,Objectivity, Prediction and Self-reference 6.2.5.1 The Ecosystemic Position 1 SCience and Prediction A central tenet of constructivist thinking, which Keeney adheres to, is that our hypotheses about the world cannot be directly provable. The basis of thisidea rests on the principle that the interests and activities of the scientific observercannot be dissociated from his observations. Thus, scientific knowledge can no longer be regarded as objectively knowable, ~olute nor universally acceptable.The implica tion of this isthat the "pure" sciencesas we knowthem, can no longer be regarded as neutral or objective. Similarly, psychotherapy can no longer be regarded as an "objective", valuefree enterprise, and human behaviour cannot be fully predicted or unilaterally controlled. Keeney (1983a), rejects manyofthe assumptions underlying the traditional "scientific" method. Hisfocus is on the cybernetics of cybernetics and thus upon pattern and form, whichare conceptswhich have no "realness" and whichcannot, therefore, be subjected to quantification. For Keeney, sincethere isno such thingas an observer free description that can be objectively assessed or evaluated, hisviewexcludes the possibility of prediction based upon such description. AsJoubert(1987) notes, each meeting with a clientor subjectisa unique occurrencewhich takes placeat a given momentin the observer's epistemology. -65- Family Therapy: Strategic and Ecosysfemic Approaches 2 Objectivityand self-Reference Cybernetics of cybernetics places the observer in that which is observed. Thus all description becomes self-referential. It avoids the premises of "objectivity", which assumes thatonecan separate the observer and the observed, and looks at recursive relationships.Keeney quotes Rollo May is this regard. "We don't investigate nature, we investigate theinvestigator's relationship to nature" (in Keeney, 1979, p.122). Froman ecological perspective where relationship and balance arestressed, the idea that one person can exercise unilateral control over another is unacceptable and impossible. Clients or subjects influence the therapist or researcher's behaviour as much as vice versa. The idea that one is able to "manipulate" variables or subjects in research also does not make sense from such a perspective. For Keeney, the alternative to both objectivity and its complement, subjectivity, is ethics which recognizes the necessary connection between the observer and the observed and looks beyond to how the observer participates in the observed. When one draws a distinction, for Keeney, this act indicates a choice or preference, so that the therapist's view of a symptom presupposes a particular preference, intent and ethical base. The concern with objectivity is replaced with one of responsibility. It then becomes necessary to examine the intention underlying one's habits of punctuation, and to ethically consider how we participate in the construction and maintenance of our experiential universe (Keeney, 1983a). 6.25.2 Haley's Position Haley (1980), on the other hand, espouses the view that scientific research is possible and thus he appears to accept the concepts of objectivity and "truth"~ In Leaving Home (1980), Haley distinguishesbetween researchers and clinicians. For hmt "...theresearcher mustkeep distant from hisdata, be objective, andnot intrude on or influence whathe is studying. He must also explore and explain all the complex variables of every issue, since he isa seeker after truths" (Haley, 1980, p.17). Furthermore, in discussing outcome research in the same publication, it is evident that Haley subscribes to a traditional linear research paradigm where objective research is possible and outcome is studied by comparing experimental and control groups. The assumptions underlying such a view are that an objective universal reality exists which can be known and which is scientificallyverifiable. On the basis of this, one is able to make certain predictions with regard to human behaviour. Indeed for Haley the chief merit of systemstheory lies in thefact that it mak~ certain happenings predictable. Since family interaction is viewed as an endlessly repeating series of sequences, the therapist is able to recognize these and thus make predictions with regard to future behaviour or sequences of behaviour. Here Haley does however, acknowledge the difficulty in the reification which necessarily accompanies such a view. The sequences observed must be simplified so that they may become recognizable (Haley, 1980). -66- Family Therapy: Strategic and Ecosysfemic Approaches Haley distinguishes between researcher and therapist. For him, the therapist, in contrast to the researcher must be personally involved and human, not distant and objective. He tt or she must actively intrude to influence people in order that change can be effected • The positionthat it ispossiblefor thetherapist to unilaterally influence hisclient, excludes the possibility that the client influences the behaviour of the therapist, as much as his behaviour influences that of the client. The idea of unilateral influence assumes a linear and thus necessarily reductionistic paradigm of matter and energy. Keeney criticizesthe idea of unilateral control for its"trivialization" of the therapeutic context. For him such a therapist is acting upon the fundamental assumption that he or she is "in charge" of creating change and thus must remain outside the system being treated. This neglects the recursive relation between client and therapist (Keeney, 1983a). Early in his work, Haley emphasized the necessity of the therapist including himself as part of a therapeutic or diagnostic unit- "...Ethel therapist assumes that the way the family is behaving is influenced by the ways he deals withthemandtherefore he includes himselfinthe diagnostic unit ..The formulation of a family ''problem'' is inevitably a joint venturebetween therapist and family from this point of view' (Haley, 1971, p.282). However, he does not pursue this idea of self-reference to include the idea that the therapist's behaviour is similarly influenced by that of the client, or that no description can be observer-independent The concept of objectivity necessarily excludes that of self-reference. Thus there appears to be a fundamental contradiction here in Haley's work. 6.2.6 Cybernetics and the Cybernetics of Cybernetics The preceding discussion of the different positions of Haley and Keeney with respect to the nature of reality and the problem of "objectivity", indicates that each presupposes a different view of systems theory or cybernetics. Keeney (1982b) notes that cybernetics is not synonymous with systems theory. In the family therapy field the term "systems epistemology" is often used only to indicate a holistic view, in other words, that the therapist works with families rather than with individuals. On the other hand, cybernetics is concerned with moving away from a paradigm of substance to one of form, not from a concern with parts to a concern with wholes. In cybernetics, both parts and wholes are examined in terms of patterns of organization (Keeney, 1982b). In the literature a further distinction is made between simple or first-order cybernetics and second-order cybernetics or the cybernetics of cybernetics. J:l For the ecosystemic thinkers this dualistic view of therapist and researcher represents in itself evidence of a Newtonian paradigm in which either/or dichotomies are prevalent. -67- FamilyTherapy: strategic and Ecosysfemic Approaches 6.2.6.1 Firstand second-Order Cybernetics Inearlycybernetic research someengineers using cybernetic principles, developedwhat came to be known as control engineering, where the principles. of cybernetics were applied to the guidance and control of rockets as well as to the design of prosthetic devices. Cybernetics in thissensewas often onlyconcerned with the control of a range ofdeviation fora particular variable, forexample, housetemperature.Theworkofth~ engineers was termed ''first-order cybernetics" by Von Foerster, indicating that the observer remains outsidethat which isobserved (Hoffman, 1985). Varela, in a similar vein, termed this model an "allopoietic" or control model for living systems (Hoffman, 1985). This is essentially an "input-output" model, or what Keeney and others have termed a "black-box' model (Keeney, 1983a). In contrast to this, second-order cyber netics, inwhich the observer is included in the total arc of observer and observed, was proposed. This was referred to as an "autopoietic" or autonomy model in which living systems are respected in the dimension of their wholeness (Hoffman, 1985). 6.2.6.2 Cyberneticsof Cybernetics Keeney's ecosystemic epistemology includes the concept of the cybernetics of cyber netics. For Keeney, the perspective of simple cybernetics is incomplete in that it fails to take into consideration higher orders of recursion or feedback. For example, the self-corrective feedback loop of thermostat and furnace is subject to higher order feedbackinvolving man's relationship to hisclimate, which recalibrates the lower-order loop of the thermostat and housefurnace. When cyberneticians observed these higher ordersofprocess theybeganto talkoffeedbackoffeedbackor cybernetics ofcybernetics. Cybernetics of cybernetics also enables us to speak of the autonomy of whole systems where a system is viewed with no referenceto its outsideenvironment, whereassimple cybernetics permits a view of a system in the context of its relationships with outside systems. For Keeney (1983a), simple cybernetics and cybernetics of cybernetics are halves of a cybernetic complementarity which encompasses both. While either view may be used at a given time for pragmatic purposes, the larger whole of which they are both a part mustbe recognized. 6.2.6.3 Strategic Therapyand Simple Cybernetics Haleydescribes human beings "...not as separate individuals, but as an ongoing group responding to one another in homeostatic ways..." (Haley, 1980, p.15). Furthermore, the family system isstabilized byself-corrective, governing processes whichare activated in response to an attempt to introducechange into the system (ibid). This represents a first-order cybernetic description. Adangerinherentinsuch a first-order cybernetic view, isthat it does not recognize that suchpunctuations representpartial arcsor approximations ofwhole, moreencompassing patterns. For example, symptoms and interventions represent approximations or metaphors for larger patternsof relationships. Simple cybernetics leadsto the viewthat such interventions and symptoms are realentities which maybe subjectedto "objective" scientific investigation. Ithasthe advantage, however, that the therapistisable to discern patternsthat maintain a particular problematic behaviour and thus focus on changing -68- FamilyTherapy: Strategic and Ecosystemic Approaches hisbehaviour ina strategic manner inorder to facilitate the system's self-correction. For Keeney significant contributions to the pragmatics of therapy have developed from this perspective (Keeney, 1983a). \ -' However, for Keeney (1982b), the application of the ideasfrom s-imple cybernetics, to/ human systems is reductionistic in that complex human interactions are looked at as black-box phenomenawith simple input-output relationships. A major criticism ofsuch a viewisthat it places an observer outsidethe phenomenon observed. This implies that the outsider is in a position to unilaterally manipulate or control the system he is observing. Keeney criticizes Haley's strategic approach as representing such a view. Whilethe abovediscussion hasviewed Haley's stanceas that ofsimplecybernetics, Mac Kinnon (1983) points out that Haley does not defend hisideasassystemic. Forher,they arise not from a systemic, but from an organizational framework and she-appears to suggest, that these ideas are therefore not subjectto the above criticisms. However, from the literature it isapparent that Haley attemptsto reconcile his concept of hierarchies within an organization withsystems theory. InProblemSolvingTherapy (Haley, 1976) he states- "It isin the ways that repetitive sequences define hierarchies that systems theory and hierarchy come together. The hierarchy is shaped by the behaviour of the people involved, and insofar as the behavior is repetitive and redundant it is a governed system that iserror-activated in that deviance activates a governing process" (Haley, 1976, pp.123-124). Mac Kinnon's viewtherefore, does not appear to be valid. 6.2.7 The "Power' Debate 6.27.1 Introduction For many authorsthe mostfundamental differences between the strategic and ecosys temic approaches to family therapy are epitomized in the debate between Haley and Bateson with regard to the issue of power (Dell, 1989; Keeney, 1979; 1982a; 1982b; 1983a; Rabkin, 1978;0he debate dates back to the early days of the double bind project and for some IS still irresolvable (Dell, 1989). Indeed, Richard Rabkin (1978) refers tothisdebate asrepresenting the"...epistemological core offamily therapy' (Rabkin, 1978, p.485). Keeney (1983a) suggests that the differing orientations of Bateson and Haley reflect a fundamental difference in epistemology and "...signify the contrast betweenan epistemology ofpattern andone ofmateriaf' (Keeney, 1983a, p.96).All other differences betweenthe two approaches are subsumed under this. 6.27.2 The Debate in Context Hoffman (1985), places the debate in context. For her the issues emerged 'during the ColdWar yearsa-nd reflected the "zeitgeist" of the timeswhich were centred around a fascination withcontrol, asthe super-powers viedforworlddominance. Early cybernetic research occurred within a military context and was concerned with experiments with guided missiles and rockets as well as with the investigation of the field of artificial intelligence. -69- Family Therapy: strategic and Ecosystemic Approaches The division which emerged between Bateson and hiscolleagues in the field of family therapy paralleled that between the "controf' engineers and those researchers who rejected what theyviewed as an exploitative useoftechnology, basedon a false illusion of objectivity. Theyfavoured a model which viewed 1iving systems as autonomousand which needed to be respected inthe dimension oftheirwholeness ratherthan regarded as objects to be manipulated by man (Hoffman, 1985). Withregard to the family therapyfield, Hoffman notesthat the articles on family therapy whichemergedfrom PaloAlto at thistimewere "... imbuedwith a vocabulary basedon war and adversarial games: "power-tsaics', "strategy'~ being "one-up" or "one-down" (Hoffman, 1985, p.382). This language reflected the dominantvaluesystem ofWestern scienceat the time; a viewwhich Bateson rejected. 6.2.7.3 Haley's World View Ithasbeen pointed outthat the difference betweenthe views of Bateson and Haley with regard to the problem of powerreflects fundamental epistemological aswellasontologi cal differences. ForHaley, poweriscentral to all human relationships. "...how much powerone person wouldaI/ow another to have over him [is] a central issue in human life" (Haley, 1981, p.23,footnote). "The struggle for status andthe question ofwho isgoing to be incharge, is basic to human relationships" (cited in Dell, 1989, pA). Thus, as Dell points out, by implication, thisquestion is basic to human nature.A corollary of Haley's viewthat all learning creatures are compelled to organize, is that in so doing they form a status, or power ladd~ Hestatesinthisregard: "We maydream ofa society in which aI/ creatures are equal, but on this earth there is status and precedence and inequality among all creatures" (Haley, 1976, p.1 01). Sucha hierarchy ismaintained byallparticipants inthateverycommunication exchanged serves to define hierarchical positions. Moreover, when such hierarchical positions are violated, participants of higher as well as lowerstatus will act to enforce it ForHaley, the struggle for power in organizations defines psychopathology. He states: "I think powerisat thecenterofpsychopathology andthebestwayto thinkofsymptoms is as an expression of a powerstruggle" (cited in Dell, 1989, pA). An individual who showssymptoms reflects an organization with a confused hierarchical arrangementand consequently a powerstruggle arises inorder to clarify the postions in the organizational hierarchy. The context of therapy is likewise described in terms of a similar struggle and Hale* speaks of power and control games between clients and therapist Following Milton Erickson, Haleydescribes the practice of therapy as a set of maneuvres, strategies and countermaneuvres between therapist and client as they seek to control one another (Dell, 1989). Thus, for Haley, power isa fundamental and inevitable aspect of human existence. 6.27.4 Power as Epistemological &ror ForBateson, on the other hand, powerisa lineal, epistemologically incorrect ideawhich isinconsistent withthe systemic position (cited in Dell, 1989). Bateson sees this issue as -70- Family Therapy: Strategic and Ecosystemic Approaches reflecting a basic epistemological difference between Haley and himself. In this regard he states: "Haley slides too lightly over vel}' real epistemological differences between himselfandme...he believedinthe validity ofthemetaphorof"power' inhumanrelations. I...believe...that the myth of power always corrupts because it proposes always a false (though conventional) epistemology" (cited in Haley, 1981, p.54). For Bateson the metaphor of power reflects a lineal, Newtonian epistemology: "In principle allmetaphors derived from a physical worldof impacts, forces, energy, etc are unacceptable in explanationof events and processes in the biological worldofinforma tion,purpose, context, organization and meaning. The"power' metaphormust therefore be lookedat asa functioning falsehood orerror, causing whatpathologies? Self-validating to what point?" (Bateson, 1974, p.26). Thusfor Bateson, Haley's use of the metaphor of powerisan eptistemological errorwhichisself-validating and potentially pathological. 6.27.5 Poweras a Contradiction in Logical Types Keeney (1979; 1982b; 1983a)elaborateson thiscriticism .. ForKeeney, Haley implies a contradiction inlogical types, when he describes the therapist's presenceinan ecosystem in terms of poweror control, since he is using metaphors from lineal epistemology to describe relationships. Keeney sees Haley's use ofthe metaphorof power being derived from his notion of hierarchy which,according to Keeney, he conceptualizes interms of a linear progression of power levels. Auerswald describes the notion of hierarchy involving higher and lowerlevels as a "...Iinguistic hangover from the Newtonian version of reality" (Personal communication to Keeney, 1977, cited in Keeney, 1979, p.123). The notion arises from a nonecosystemic epistemology and isanti-ecological. For Varela then, ifone looks at a system in a linear, hierarchical way, it is not possible to see the wholesystem (Varela, 1976, cited in Keeney, 1979). 6.2.7.6 Poweras Punctuation For Keeney, seeing ''power' in any context isthe result of a way of punctuating events. To saythat a therapist and clientare engaged in a "power struggle", is a punctuation of the contextof therapy in a way that constructs that view. Power is in the hand of the punctuator, and not necessarily in the observed. Forecosystemic thinkers, to punctuate events in the biological world in terms of Newtonian metaphors, leads to pathology which is described in terms of ''fractionating of complexity' or "destruction of patterns that connect' (Keeney, 1982, p.156). It isthe distortion of cybernetics, (that is, simplecybernetics), which posits the observer outsidethe phenomenon observed, and this leads to the idea that the outsider is in a position to unilaterally manipulate or controlthe system he isobserving (Keeney, 1982b). Hoffman (1988) elaborates on this view. In her view, power is always attached to a contextof relationships, not to a person. The therapistcannot be in controlas he or she is partof a mutual system of influence. The idea of powerobscuresthe recursive nature of this therapeutic system. For Hoffman, the notion of power and control places the therapist inthe position ofan "expert system" who isina postion to knowwhat a"normal' family structureis and who then actsto lessen the deviation from thisnorm.This involves setting up descriptions of pathology which are made to seem "objective" and "reaf'. In thiswayinformal diagnostic categories haveemergedsuch as"dysfunctional family', and "cross-generational coalitions", whichsuggest that the family isresponsible for distress in the individual and locates blame in the family structure(Hoffman, 1988, p.66). -71- Family Therapy: Strategic and Ecosystemic Approaches 6.27.7 Powerand Transitivity For Bateson, the main criterion separating the metaphor of power from ecosystemic epistemology has to do with "transitivity". In other words, more power will always be more powerful. He sees poweras the attempt to maximize anygiven variable and thus, asthe attempt to increase and control that variable. The exercise of such power in an ecosystem leads to destructiveness and pathology. This idea is anti-biological and anti-ecological. In termsof ecology, goods are often intransitive, so that they become toxic if they exceed some optimum, for example, population, oxygen, protein. For Bateson, the planetfaces ''points ofno return" asa consequenceofsocial policy, created by an epistemology of power (cited in Keeney, 1979, p.123). Bateson warns of the consequences of pathology being created by therapists who implementstrategies on relationship systems, through an epistemology whichcontainsmetaphors of powerand control~eeney (1983a) continues, that to suggest that the therapistissoleyresoponsible forchange, implies a lineal, transitive relationship, so that one mayassumethat the more skilled the therapist isthe more power he hasto achievechange.This ispotentially toxic as it mayleadto the therapist becoming less and less flexible and creativeand therefore, less effective (Keeney, 1983a, p.131). 6.27.8 Poweras a Sourceof Pathology As Dell (1989), points out Bateson does agree with Haleythat power is an overriding human concern. However, for Bateson, the beliefin power entails an epistemological error which breeds pathology. Keeney stresses this point For him the cybernetic argumentisnot whether powerexists. The question is epistemologically irrelevant as it cannot be objectively proven or disproven. For Keeney the criticism is directed at the consequences of an epistemology which habitually punctuates the world in terms of power.According to Bateson, such punctuation reinforces greedand corruption inthose who believe in the "reality" of "social power" (Keeney, 1983a). 6.27.9 The Therapist as ·Part in an Ecosystem· Bateson argues that these metaphors should be replaced by an ecological metaphor, namely ''part in an ecosystem". Inthisway the therapistisalways part of the system and subjectto itsconstraints and necessities. He is''part in" or ''part of' ratherthan an outsider, spectator, manipulator or power broker. For Bateson whole systems are defined, identified and constituted by mutual, reciprocal and simultaneous interactions, since all partsinan ecological system simultaneously act on one another. ForBateson, "...no part oLan internally interactive system can have unilateral control over the remainder or overany otherpart" (Theterm "controf' refers to the whole self-corrective system and not to a unilateral influence from the therapistto any other member.) (Bateson, 1971a, p.5). According to Keeney (1983a), the therapists' presencehelpsto determinehowthesystem isorganized. Theway he ispartoffeedbackwill result in particular waysinwhichfamily members organize their behaviour around him. Their reaction leads to the therapist organizing his behaviour around them again, and so on. For Keeney, "...the most a therapist can do is vary his behaviour, recognise the subsequent behaviour of those in thesurrounding social field, andmodify hisreaction to their reactions". This, for Keeney, does not constitute coritrol (Keeney, 1983a, p.132). -72- Family Therapy: Strategic and Ecosysfemic Approaches 6.27.10 Criticismof the Ecosystemic Stance The debate with respect to the question of power continues today within the family therapyfield and hasmoved beyond a disagreement betweenadvocates ofstrategic and ecosystemic positions. From within the field, the position of Bateson and Keeney has been subjectto criticism. 6.2.7.11 Golann - Unacknowledged Power Golann (1988) argues that the approacheswhich appear to rejectthe notion of power and control, suchasthose informed byconstructivism, have not led to a less intrusive or less hierarchical family therapy. For him the introduction of "new information" into a system isan exercise of unacknowledged power. Golann terms those interventions where the therapist's hypotheses are ", ..invisibly communicated by the pattern that connects the therapist'S questions", and which he attributes to Keeney in particular, "unconscious persuasion" (Golann, 1988, p.56). He refers to these as ethically more objectionable than explicit strategic interventions. He seessuchinterventions asdishonest and thusascreating an evengreaterpowerhierarchy in favour of the therapist (Golann, 1988, p.63). The idea of the family construction of reality compounds and obscures the problem of power. ForGolann, "Power obscured eventually emerges - a therapeutic wolfcladas a second-order sheep"(Golann, 1988, p.56). 6.27.12 The Problemof Violence - Feminist Critique Bateson and other ecosystemic thinkers have been criticized by feminists, as well as others in the family therapyfield for their failure to deal with the problems of power, inequality and violence. Thesystemic perspective with its emphasis on circular causality makes it difficult to deal with such apparently lineal phenomena such as power and violence. Feminist writers have protested that thisstance gives the power of men over women in patriarchal societies, the inequality in the status of women, the abuse of women and children and family violence in general, the quality of an illusion. 'Goldner, (cited in Dell, 1989), understands Bateson and hisfollowers to be saying that the oppression ofwomen isa lineal, epistemological error in thinking and assuch does notdeservevalid consideration ina therapist'S viewof problem within a family. Similarly, MacKinnon and Miller, (cited in Dell, 1989), point out that the arguments of the ecosystemic thinkers haveclosed anyfurtherexploration concerning the natureofpower. Jamesand Mcintire, (cited in Dell, 1989), stress that cybernetic systems theory makes it impossible to pose questions regarding the power politics of traditional sex roles, the family'S division of labour, the statusof women in families and societies, as well as the problems ofviolence and abuse. Theystate: "Systems theory's inability, as distTnct from its failure, to frame these questions is its own indictment" Oames & Mcintire, cited in Dell, 1989, p.7). For Luepnitz (1988), whilesome dialectical relationships, such as thermostatand room temperature,do not involve a powerdifference, otherssuchas that between parentand child, employer and employee, do. It is true that the less powerful can almost always influence the more powerful, but there is a vast difference between influence and legitimate power. Forexample, children influence parentsbytrying out new behaviours, -73- Family Therapy: StrategiC and EcosystemiC Approaches but it isnot ina child's powerultimately to define his or her behaviour as''good'or "sick', which iswhat parents and professionals do. She includes inthe definition of power, the ability to categorize, define or name things. Incybernetic family therapy, it maybe that men who abuse their wives are described as being in a "complementary dance" with them. While this may afford the therapist therapeutic leverage, it fails to recognize that the social institutions with the power to namethings, forexample, psychiatry and law, privilege the malepartner.WhileLuepnitz agreesthatwomencolludeintheirown powerlessness, shestresses that cognisance must be taken of the rolesuch things as economicfactors playin keeping women in abusive relationships. For her: "Women do participate in theirown abuse, but not as equals" (Luepnitz, 1988, p.S3). 6.27.13 The Assumption of Equal Interactional Influence Speed (1987), alsoaddresses the issue of inequality and family violencefrom within the family therapyfield. She questions the assumption of equal interactional influence, that is, the assumption infamily therapy, that family members haveequal ability to influence each other and, that therefore, no-one is more responsible than anyone else for the patternswhichexist Forexample, thewifenags tothe extentthat the husbandwithdraws and viceversa. Thereis a difficulty with this assumption with regard to family violence and sexual abusewhich, although theystill reflect relationship patterns, they are alsothe consequence of an adult in a family having greater power and thus ability to influence and control others. She citesthe example of the master-slave relationship where there is an equal fit and complementarity between the two roles, but still an unequal distribution of power and influence over all aspects of life. She continues to question that if this asymmetry of power exists in physical and sexual abuse, does it not exist elsewhere in other less contentious interactional patterns. For example, the wife's nagging mayinfluence the pattern more than the husband'swithdrawal. 6.27.14 Dell-An Attempted Resolution The cybernetic perspective, with itsemphasis on circular causality, on pattern, holistic interaction and context, obscures the existence of lineal power and is constitutively .unable to distinguish or speakof power (Dell, 1989). Dell (1989), attempts to resolve the issue. He proposes that since violence and power belongessentially tothe domain of humanexperienceand description, we are permitted to use metaphors of powerand lineal control indiscussing these issues, sinceexperience isconstitutively lineal. On the'other hand in the domainofscientific explanation, which isthe domain Bateson is referring to when he uses the terms power and lineal control, these termsare inadequateand epistemologically incorrect. Inthe same waya circular, causal explanation isnot valid in the domain of human experienceand empathy. Thus Dell sees Bateson as correct in referring to the useof power as an epistemoligical error, but such a view is incomplete, since maneuvers for power represent a highly visible "epiphenomenon" of some other process basicto human nature (Dell, 1989). While systems theory is a powerful conceptual tool, it has limitations in its inability to offeran adequate understanding of humanviolenceor addressthe problemof individual responsibilty. Laing, (cited inDell, 1989),emphasizes that the systemic conceptualization should not be used to obscure violence. Such "mystification" obscures individual -74- Family Therapy: Strategic and Ecosysfemic Approaches responsibility. While violence and power belong to the domain of human experience, this cannot be invalidated by theory. For Dell"...the invalidation ofpowerand violence in the domain ofsystemicexplanation [isJ a deliberate choice thatnecessarily follows from adoptinga systemic perspective, and isa fundamental limitation of thatperspective II (Dell, 1989, p.t). However, the systemic view is not a valid disqualification of the human experience of violence and power. 6.3 Methodology 6.3.1 Aesthetics and Pragmatics 6.3.1.1 Definitions The Concise Oxford Dictionary defines these terms in the following manner- Aesthetics refers to the philosophy of the beautiful or of art (COD, 1976, p. 17). Pragmatics, on theotherhandisa philosophical doctrine thatevaluates anyassertion soleyby itspractical consequences and its bearing on human interests (COD, 1976, p.868). 6.3.1.2 Haley - Emphasis on Pragmatics Haley's position reflects a pragmatic approach to therapy. He describes theory only in terms of its utilitarian value for outcome in therapy. A theory is useful if it leads to successful outcome; if it is conceptually uncomplicated; if it generates hope in therapist and clients; if it isable to define failure and account for itsoccurrence; and, it appears, most}mportantly,'7he theoryshouldguidea therapist to action rather than to reflection. It shouldsuggest what to do II (Haley, 1980, pp. 9-10). On the other hand, he rejects theories which preventa clear definition of goals,lead to poor therapy outcomeor which, as a result of complexity, are incapacitating on a pragmatic level. He rejects theories which lead to philosophical speculation rather than action. Thus, for Haley theory is important only insofar as it leads to effective practical action. He emphasizes that clinicians require simple theories, which focus on key variables and allow them to act (Haley, 1976). While he adheres to a systemic/organizational framework, it isevident that Haley values what works in effecting change more highly than purity in application of theoretical principles. He also insists on explicit goals against which therapeutic outcome can be measured. AsMac Kinnon(1983) notes, from an ecosystemic or cybernetic point of view, systemic transformation is unpredictable and consequently outcome is difficult to determine. For Keeney, (1983a), the aim of achieving specific goals cannot take into account whole ecological contexts. It is a fundamental principle of ecology that an ecosystem will heal itselfif left alone and it is the task of therapy, merely to provide the context within which a system will find its own adjustments (Keeney, 1983a). Thus Haley's insistence upon setting goals for therapy would appear to reflect a linear approach. Byspecifying, a desired outcome for therapy, albeit in conjunction with the family, the implication is that the therapist is responsible for change. This also assumes -15- Family Therapy: Strategic and Ecosystemic Approaches the possibility"that the therapist isable to unilaterally influence the system (Mac Kinnon, 1983). \ 6.3.1.3 Keeney - Critique of a Purely PragmaticApproach I WhileKeeneyacknowledges the importance ofthe pragmatics oftherapy,and hecredits the strategic therapists, including Haley, with identifying and disseminating effective techniques for facilitating therapeutic change, he alsocriticizes the pragmatic approach as reductionistic (Keeney, 1981; Keeney & Sprenkle, 1982).ForKeeney, Haleyand other pragmatic therapists are reductionistic inthat theyaccentuatethe importance offocusing onlyon observable and quantifiable sequencesof behaviour. The pragmatic perspective isprimarily concernedwith reducing and simplifying phenomena for practical purposes. Behaviour outcomes are stressed and ideas, toolsand techniques are evaluated on the basis oftheirutility inachieving successful outcomes. Theory isuseful onlyifitcontributes to creating and implementing strategies for therapeuticchange. Keeney argues that the pragmatic perspective arises from simplecybernetics where the family is~n asa black boxandsymptoms, aswellas interventions, areviewedas"inputs" to the system. Inaddition, the therapist isnot seen as partof the system beingobserved and the morecomplex ordersof unconscious process are disregarded (Keeney, 1983a). The reductionism isfurther obvious where therapists argue that therapy mustfocus on the presenting problem and interventions mustbe designed, and the outcome evaluated intermsof thiscriterion.\While it isacknowledged that a larger unit maybe the one that mustchange, it is believed that thiswill occur viafocus on the presenting problem. This is unacceptable for Keeney. This punctuation does not adequately account for the complexity of human experience and interaction and he posits a need for a more metaphorical description of therapy (Keeney, 1983a). 6.3.1.4 Aesthetic Therapy Bateson defines aesthetics as"...responsiveness to thepattern which connects" (Bateson, cited in Mac Kinnon, 1983, p.431). The aesthetically oriented therapist is sensitive to holism and complexity and stresses the need to increase and expand his own under standing and appreciation of the patterns that characterize therapeutic contexts. Aes thetic therapists are concerned with their own growth as well as that of clients and colleagues. Keeney (1983a), describes an aestheticunderstanding ofchangeas a respect, "wonder, and appreciation of natural systems which is frequently overlooked by psychotherapy. Technique is not primary, rather the focus is on questions such as, whether the patterns of therapy are elegant, or are concerned with what constitutes health. 6.3.1.5 Dialecticof Aesthetics and Pragmatics According to Keeney, his ecosystemic approach is guided by both orientations and is responsive to issues of both pragmatics and aesthetics. However, he views pragmatics and aesthetics as representing different logical levels. Issues of aesthetics cannot be answered from the level of pragmatics and vice versa. If the two levels are mixed, confusion arises. ForKeeney ecosystemic epistemology mustincludeboth reductionism and holism, pragmatics and aesthetics. Ithasto embodytwo patterns. On the one hand, when guided "by ecosystemic pragmatics, the therapist moves in a reductionistic and -76- Family Therapy: Strategic and Ecosystemic Approaches specific direction, and on the other hand, moves in a holistic direction when he is concerned with ecosystemic aesthetics. The two patterns are integrated in a dialectical relationship (Keeney & Sprenkle, 1982). 6.3.1.6 The Relationship of Theory and Practice While family therapists have often used techniques or strategies which were derived from cybernetics, for Keeney they do so without taking into account ecosystemic aesthetics. Bateson has also stressed this point, "...the ecological ideas implicit in our plans are moreimportant than the plans themselves, and it would be foolish to sacrifice these ideas on the altar of pragmatism II (Bateson, cited in Keeney & Sprenkle, 1982, p.3). The position Haley takeswhen he largely rejects theory, misses the vital and necessary connectionbetweentheoryand practice, ideasand action,or aesthetics and pragmatics, according to Keeney and Sprenkle, (1982). Moreover, the dissociation ofthese reinforces the false Western dualism of mind and bodywhich, according to Bateson, represents an epistemologicl errorwhich maintains various forms of pathology. Once more it isstressed that it isimpossible for a therapistnot to havean epistemology. For Keeney and Sprenkle, (1982) theory is defined as a description of the relationship betweenone's epistemology and habits of action.Although a therapistmaybe unaware of hisepistemology, theoryisalways partof hisbehaviour. All strategies or interventions presume underlying ideas, theories and epistemologies that in part generate the strategies. Whilethere isa distinction between epistemology and action, and between aesthetics and pragmatics, there isalways a relationship between the two levels so that they interactwitheach otherand inthisway modify and temper one another. For Haley, on the other hand, a discussion of epistemology is not germane to clinical work (Mac Kinnon, 1983). 6.3.1.7 Aesthetics and Art Keeney and Sprenkle (1982), state that aesthetics necessarily represents a higher level of abstraction than pragmatics, since it is important that an understanding of theory precedes putting into practice its pragmatic consequences. For these authors, under standing theory facilitates more effective and thus less harmful therapy. Similarly they criticize those schools of family therapy which are based on an attempt to reduce the "art" oftherapy, totechniquesthatcan beexplicitly taughtand evaluated.Theydistinguish between pragmatic techniquesand art, which isviewedas being moreaesthetic, so that training and the practice of therapyfocuses on the character building of the therapist. For Bateson, art involves the problem of judging the ecological implications of a course of action as it becomes incorporated and assimilated into the total context (cited in Keeney &Sprenkle, 1982, p.12). Foran artist, the practiceof a skill isimportant in terms of the way it becomes part of a whole ecology. Thus for the ecosystemic therapist to becomean artist, itisnecessary to acceptthe dialectical relationship between pragmatics and aesthetics. -77- Family Therapy: Strategic and Ecosystemic Approaches 6.3.1.8 Pragmatic Therapy as a Potential Source of Pathology While pragmatic techniques may provide immediate symptomatic relief to some piece ofthe ecosystem, forKeeney and Sprenkle, (1982), theydo nottakeaccount ofthe larger context. Pragmatics isconnectedto a shorterfamework, asexemplified by brief therapy. On the other hand, aesthetics represents a broadertime framewhere technique isused to postpone immediate change, but effect more profound change in a broader time scale. Thus symptoms are regarded, not as bothersome, but as the "motor for growth" (Keeney & Sprenkle, 1982, p.13). Theyreferto the difference betweenstrictly pragmatic and strictly aesthetic approaches to family therapy in terms of the difference between "band aid'and "character rebuilding" approaches (ibid). Furthermore, the strictly pragmatic approaches are regarded as ecologically dangerous, leading potentially to higher order problems. ForBateson, "...mere purposive rationality unaided by such phenomena as art, religion, dream, and the like, is necessarily pathogenic and destructive of life;..." (Bateson, cited in Keeney, 1983a, p.188). He suggests that pathology maybe perpetuated bytherapists who workwithoutan aesthetic orientation. Suchtherapists necessarily regard themselves as unilaterally ableto influence a system. However, they are onlydealingwith partial arcs of cybernetic systems and so threatenthe recursively structure biological world. Itisnecessary, therefore,to recognise the larger ecology ofproblems and to contextualize the techniquesoftherapybycoupling these to higher ordersof cybernetic process (Keeney, 1983a). 6.3.1.9 The Need for an Integrated Approach ForKeeney and Sprenkle, (1982), concern fortechnique and pragmatics withoutregard for the broaderaesthetic contexts, leadsto the vulgarization of technique. On the other hand, an attempt to achieve aesthetic standards without regard for technical mastery leads to vulgar art (Keeney & Sprenkle, 1982, p.13). For Keeney, an ecosystemic epistemology involves the interaction of both the level of pragmatics and that of aesthetics. An integrated approach to family therapy must embody both the aesthetic and the pragmatic, so that technique istempered byaestheticconcern, and theoretical speculation by pragmatic demands. "/n order to be a whole therapist, aesthetics and pragmatics mustnot be two " (Keeney, 1981, p.2). Keeney (1983a), alsostatesthe desireto avoidanytypeof"either/or" dichotomy between aesthetics and pragmatics. He views aesthetics as a contextual frame for practical action. '~singu/ar emphasis upon pragmatics potentially leads to an ecological decontextualiza tion of therapy where one'sbagof tricks, cures, and problem-solving procedures is too easily disconnected from themoreencompassing aesthetic patterns ofecology. Similarly, an aesthetics of therapy without appropriate regard for pragmatic technique maylead to free-associative nonsense" (Keeney, 1983a, pp.8-9). 6.3.1.10 Critique of Keeney's Position While Keeney here stresses the need for an integration between aesthetics and prag matics, a review of the literature suggests that he does not altogether achieve this. By far the major proportion of his work is devoted to the discussion of theory, with comparatively little description of the implementation of these ideasin clinical practice, aside from the general principle that the therapist has to convey messages of change, stability as well as a relevant Rorschach tc:> a "troubled ecology'. It appears from the -78- Family Therapy: Strategic and Ecosysfemic Approaches literature reviewed in thisstudy, that Keeney's cybernetic family therapy requires more attentionto the development of an appropriateaccompanying methodology. 6.3.2 Techniques of Intervention - Process or Content Focus 6.3.2.1 Defin~on of P~~sJnFamilyTherapy-Terminology Thosefamily therapy approaches which stress process, are concerned with describing the sequence of interaction, or the interactional pattern within which a symptom or a presenting problem isembedded (levant, 1983).Thesymptom isseen as a communica tive act within an interactional context. The focus in family therapy approaches which emphasize process, isthuson the directobservation ofthe interaction of family members (levant, 1983). 6.3.2.2 Haley - The Focuson Process While Haley moves to a focus on structure as he becomes more concerned with the conceptsoforganization inhis work, the focus of his strategic therapyisalmostexclusively on process, rather than content, in terms of the above definition. Haley defines an organization in termsof the repeating sequences of communication which characterize it (Haley, 1980). Forhim, behaviour which forms a repetitive sequence and includes the symptomatic behaviour is of primary interest Indeed, he regards the chief merit of systems theory to be that it allows the therapistto recognize such repeatingsequences and make predictions and plantherapyaccordingly (Haley, 1980). On the basis ofthesesequences, Haley infers the hierarchical organization of the family, bynotingwho tells whom,whattodo, and whatcross-generational coalitions areformed. Inorderto effectchangeinthe system, itisnecessary to alterthe sequencesof behaviour betweenmembers ofan organization, and inso doing, alterthe hierarchical arrangement within the family. Haley intervenes at the level of behaviour by prescribing tasks which are designed to interrupt the usual interactional sequences in the family. When these sequenceschange, the individuals in the family undergochange (Mac Kinnon, 1983). Haley (1976), defines therapeutic change as a change in the repeating sequences of behaviour of a self-regulating system. A desirable change would be where the system changes intoone of greaterdiversity (Haley, 1976, p.1 05). Changeiseffectedwhen the therapist intervenes inthe repeating sequences of behaviour insucha waythat itcannot continue.A simple goal, for Haley, would be to devisea strategy which would change a sequence bypreventing coalitions across generational lines. For example,the therapist may change a sequence where the father consistently joins with a child against the mother, and consequently, the family will begin to function differently and the individual members will no longer experiencesubjective distress (Haley, 1976). 6.3.2.3 The Ecosystemic Focus on Process and Content For Keeney, on the other hand, effective therapeutic change requires that the therapist conveys messages of change, stability, as well as a source of "meaningful noise" or an appropriate semantic frame, to the system (Keeney, 1983a). The therapist observes interactional patterns in a family, and introduces semantic and political frames which shift the current interactional patterns and alter the meaning of the client's problem (Keeney, 1987). In cybernetic family therapy it isnecessary forthe therapistto introduce Family Therapy: Strategic and Ecosysfemic Approaches randomness intothe system from which,( since it represents something new), structural changecan take place. Keeney emphasizes that this random noise must be meaningful to, or show a "fit", with the system. The client must assumethat there is meaning to it. His searchfor meaning will then generate new structure and pattern. It maybe derived from family history, cultural myths, religion or stories which emerge from the frame of reference of the client (Keeney, 1983a). From this description it is apparent that cybernetic family therapyemphasizes notonlyprocess, (interactional patternsor political frames), but content aswell, in termsof semanticframes or "meaningful noise". Keeney (1987; Keeney & Ross, 1985), refers to the focus on interactional sequences,or process, as a ''politiear' frame of reference. He regards Haley's strategic therapy as stressing the politics of communication in terms of a ''who-does-what-to-whom-when'' focus. A political frame of reference indicates how communication is organized in a social context. However, anyascription of meaning to such a political sequence implies the introduction of a semantic frame of reference. For Keeney and Ross, (1985), all therapies construct semantic as well as political frames of reference. Semantic frames viewcommunication as the specification of meaning, so that they provide a viewof the meaning which the family's experience has for them. Semantic and political frames of reference are recursively and dialectically connected, so that any thinking about a political frame ofreference isalways done insomesemantic frameand viceversa (Keeney & Ross, 1985, p.21). In terms of the above description of the process of cybernetic family therapy, the relationship between communication of change and stability to the family system is a particular way of describing its political frame of reference. On the other hand, the meanings that are associated witha particular political organization arisefrom semantic frames of reference (Keeney & Ross, 1985). Thuswhile Haley focuses only on process, Keeney is concerned with the dialectical relationship between process, (politics) and meaning or content, (semantics). AsMac Kinnon (1983), points out, the focus of cybernetic epistemology isinformation. Bateson defines information as a "difference that makes a difference" (Bateson, cited in Mac Kinnon, 1983, p.429). Such a focus on the differences in behaviour, relationships and events, as well as differences between family members, with regard to particular issues, leads to an understanding of the circular processes involved in a system such as the family. Forecosystemic therapists, the current behaviour of the family is a product of itsepistemology and represents a message or metaphor to the rest of the system, of its current functioning. Thus, the content or meaning that family members attach to events and behaviours is of great significance and guides therapists to make suitable interventions in the family (Mac Kinnon, 1983). 6.4 Summary and Conclusions Inthischapterthe strategic and ecosystemic approacheswere compared and contrasted along a number of different dimensions, which incorporated both theoretical and methodological criteria. It isapparent that the differences which emerged between the two approaches reflect significant and fundamental differences in epistemology. -80- Family Therapy: Strategic and Ecosystemic Approaches --Chapter 7- Summary and Conclusions Family Therapy: Strategic and Ecosysfemic Approaches 7.1 Introduction The rapid development of the family therapy field in a relatively short period, initially gave rise to the development of a plethoraof clinical techniques. Asthe field turned its attentionto theorydevelopment and began to investigate in particular, systems theory, the issue of epistemology has become increasingly relevant. With the focus on epis temology, a division hasarisen between pragmatically orientedtherapists and thosewho espouse an aesthetic approach rooted in Batesonian epistemology. This study was undertaken inorderto investigate conceptual differences betweenthe two approaches, as represented bythe workofJayHaleyand Bradford Keeney, respectively. The assumption on which the study proceeded, was that there existed fundamental differences between these two approaches at the level of epistemology. These epis temological differences, inturn reflected a shift taking place inthe ideas informing both the natural and behavioural sciences, from a traditional Newtonian paradigm of matter and energy to an alternative paradigm which emphasized pattern, information and ecology. Thedevelopmentofthe family therapyfield wasexamined inthe contextofthistransition and itwasconcluded that family therapyrepresents a paradigmatic shiftinconceptualiz inghuman behaviour, which isdiscontinuous with previous methodsof conceptualiza tion.This shift parallels the adoptionof an alternative epistemology inthe othersciences. 7.2 Epistemology and the Family Therapy Field With the move towards an alternative paradigm, the concept of epistemology became increasingly popular in the family therapy literature. However, the use of the concept within the field appears to reflect a lackof understanding of the term. An attempt was made in the studyto clarify the meaning of the term, both in termsof itstraditional use within the discipline of philosophy, aswellas intermsof itscurrentusewithin the family therapyfield. Itwasconcludedthat a lackof clarity continuesto characterizethe use of the termwithin the family therapyliterature. This reflects, at leastpartially, the confusing use of the term by influential writers in the field, notably Gregory Bateson. 7.3 The StrategicTherapy ofJay Haley The studycontinued to examineingreaterdetailthe strategic therapyofJayHaley. The significant influence on Haley's approach of the workof Milton Erickson, as well as the ideas developed during his association with Gregory Bateson on the Double-Bind research project, were noted. The concepts of power, organization and hierarchy are centralto Haley's work and characterize his approach in termsof theory, as well as his therapeuticinterventions. These ideascontinue to be evidentovertime as Haley's work develops from a concern with the processes of communication in relationship systems to an emphasis on the structure of organizations. The conclusion was reached that Haley's primary concern is with pragmatics. Although he devotes attention to the exposition oftheoretical principle, for Haley, theoryisuseful onlyinsofar as itcontributes -81- Family Therapy: Strategic and Ecosystemic Approaches " to successful therapyoutcome.This isevaluated in termsof a change in the presenting problem originally presented bythe client. 7.4 Keeney's Ecosystemic Epistemology Keeney's approach reflects a well-developed, systematic theory. His work is strongly influenced by Bateson's epistemology of the ecology of relationships, as well as the assumptions of constructivism. His cybernetic family therapy is based on the concepts of the cybernetics of cybernetics and is concerned with higher orders of feedback, recursion, self-reference and the autonomyofsystems. Central to hisviewisthe inclusion of the observer inthat which isobserved. In theory and practice, Keeney attempts to transcend dualities such as health and pathology, stability and change, therapist and client. Instead these are regarded as recursively connected cybernetic complementarities. With respect to the practice of therapy, Keeney emphasizes the co-construction of the therapeutic reality byclientand therapist and calls forsensitivity to larger ecological contexts in designing interventions. Inthe discussion of his approach,itwasconcludedthat cybernetic epistemology required moreattentionto the developmentof an accompanying bodyof therapeutictechniques as partof the larger cybernetic complementarity of theory and practice. 7.5 Comparing Strategic and Ecosystemic Approaches Theaboveapproaches to family therapywere comparedalonga numberof dimensions. The primary difficulty in attempting such a comparison was that Haley'S writing did not present an explicit exposition of the premises informing his work. And thereforethese frequently had to be inferred. In describing the larger framework informing Haley's approach, his adherence to an organization description of systems where hierarchy is emphasized, reflects a lineal, non-ecosystemic epistemology. This was confirmed by Haley's apparent willingness to acceptthe idea ofan objective reality, and the collateral positions that human behaviour may be studied and described by an objective investigator and predictions with regard to future behaviour, madeon the basis ofsuch investigations. Similarly, Haley'S viewof the natureof dysfunction, as wellas the techniquesof clinical intervention, confirm an underlying lineal epistemology. It isimportantto note, however, that some inconsisten ciesand contradictions were inevitable in Haley's position due to the necessity ofmaking inferences about his standpoint on certain issues. In contrast Keeney's position with regard to the assumptions underlying his approach, hisviewofthe natureof health and pathology, his formulation ofthe natureand process of therapy, as well as his rejection of the traditional scientific method in all its facets, reflects a consistent adherence to a cybernetic epistemology of pattern and ecology. These essential differences between the approaches of Haley and Keeney were again accentuated in the discussion ofthe issue of power. Whilethe debate was not resolved, -82- · Family Therapy: Strategic and Ecosystemic Approaches itserved to crystallize the fundamental distinction between an epistemology of material and one of pattern.Atthe same timethe debate highlighted cyberneticsystems theory's constitutive inability to conceptualize and therefore,addressthe veryreal issue of family violence. This mustbe viewedas a limitation of thistheory. 7.6 Conclusion This studysetout to determinewhetheressential conceptualdifferences existed between the ecosystemic approachto family therapyas represented by Bradford Keeney, and Jay Haley's strategic approach. Significant differences have been established, which, at a fundamental level, reflect differences in epistemology between the two approaches. Whereas the ecosystemic approach is consistent with a nonlineal epistemology and reflects the transition to a new way of conceptualizing human behaviour, Haley's has not madethat transition. Whilehe treatswhole families, ratherthan individuals and uses the terminology of"systems" theory,thisalone isnot necessarily a reflection ofa nonlineal epistemology. An examination of his strategic therapy reveals it to be more consistent witha lineal epistemology. Finally, Iwish to concludeon a personal note. Throughoutthisstudy, the idea that one cannot not have an epistemology, has been stressed. It will be apparent, that while I have acknowledged that the material I have selected to include, and the distinctions I havechosen to draw upon that material, reflect myown punctuations, I have not made explicit myown epistemology in thiswork. 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