From the family system to the therapeutic system

Towards the end of the 1970s, the system most often studied in family therapy was that of the family, and the therapist was generally regarded as an outside observer. Very few therapists were interested in the therapeutic system.

This approach implicitly accepted that there existed an objective reality, external to us, a reality that had to be unveiled in order to help patients free themselves from the net in which they were caught.

Yet, from the beginning of the 1980s onwards, and more particularly after the publication in German, in 1981, of the volume edited by Paul Watzlawick, The Invented Reality (1), a new movement called constructivism spread through the world of family psychotherapists: this approach claimed descent from the work of Ernst von Glasersfeld (2), of Heinz von Foerster (3), of Humberto Maturana (4) and of Francisco Varela (4).

Then, a few years later, constructivism was in its turn attacked in the name of “social constructionism”; new forms of therapy, which laid stress on narratives or on solutions, then proposed to replace the cybernetic-systemic metaphor with a metaphor that was this time postmodern and anthropological (5). I should like to begin this introduction by briefly describing the constructivist theses, by setting out the theories of the representatives of social constructionism and the criticisms these have addressed to constructivism; after which I shall present the main schools of these two currents, as well as certain authors who have embodied these movements in the field of psychotherapy.

The constructivist sources: von Foerster, Maturana, Varela

The work of Heinz von Foerster on second-order cybernetics, like that of Humberto Maturana and Francisco Varela on perception, was in part at the origin of the application of constructivist theories to the field of family therapy.

Heinz von Foerster (6) insisted on the relation between the observing system and the observed system, showing that these two systems are inseparable. Laying the accent on ethics and granting an essential place to the bond that puts the other in relation with oneself (“that relation is identity”, he said), he considered that reality and community go together; he developed this point of view, moreover, in an introduction to an article by Francisco Varela (7), where he indicated that, in placing the autonomy of the observer at the centre of his philosophy, “Kant did not intend to carry out a movement from objectivity towards subjectivity, but rather to found an ethics, for he had clearly seen that without autonomy there could be no responsibility, nor consequently any ethics”.

Maturana and Varela (8), for their part, stressed that visual perception arises at the intersection of what offers itself to us and of our own nervous system: they showed that what we see does not exist as such, outside our field of experience, but results from the internal activity that the external world sets off in us. Maturana also established that the criteria for validating a scientific experiment have no need of objectivity in order to function: what is necessary to the researcher is not a world of objects, but a community of observers whose statements form a coherent system; this is why this biologist puts objectivity “in brackets”.

In the end, for Maturana as for Varela, language was not invented by a subject seeking to apprehend the external world; human beings are for them “languaging” beings (**), fundamentally inseparable from the web of structural couplings that language weaves.

Thanks to these constructivist thinkers, family therapists were led to discover that the mutual construction of the real in psychotherapy counts for more than the search for truth or for reality. This discovery had at least four capital implications in the therapeutic field:

• inasmuch as different couplings bring forth different, and yet compatible, worlds, a successful psychotherapy does not imply that the therapist was right, but that the construction he has built with the members of the therapeutic system is operative;
• likewise, the therapist’s intervention, instead of aiming to bring out some “truth” supposedly usable for the system or for its members, should rather tend to widen the field of the possible;
• it should be noted, moreover, that the concept of structural coupling, as Maturana and Varela elaborated it in order to describe what manifests itself at the intersection of a system determined by its structure and of a milieu in which this system is inserted (8), maintains the importance of individual autonomy and, by that very fact, of personal responsibility;
• lastly, those who, like von Foerster, refuse to separate the observer from the observed system are inevitably confronted with a self-referential paradox; they must imperatively formulate the problem in other terms in order to avoid falling back into the eternal question: how is it possible to speak of a situation in which we participate without our descriptions being contaminated by our personal properties?

The congresses of the 1980s

Among the many family therapy congresses devoted to constructivist themes in the 1980s, a few had a particular importance. One of the first congresses bearing on this domain was organised in February 1985 in Saint-Étienne, under the aegis of a psychiatrist and family therapist specialising in the treatment of intrafamilial violent behaviour; it was in the course of this encounter, in which Edgar Morin and Carlos Sluzki took part, that Humberto Maturana and Heinz von Foerster were presented for the first time to French therapists. Then the Mental Research Institute of Palo Alto organised in 1987, in San Francisco, a colloquium entitled “Maps of the world, maps of the mind”. Finally, one should add to this list the two seminars that the Gordon Research Conference devoted to the theme of cybernetics, first in June 1986 at Wolfeboro (New Hampshire), then in January 1988 at Oxnard (California): many therapists interested in the constructivist theses – among them Lynn Hoffman, Tom Andersen, Bradford Keeney, Carlos Sluzki, Karl Tomm and myself – met there.

Social constructionism: Kenneth Gergen

It was towards the end of those same 1980s that the theories of social constructionism took flight in the United States.

Kenneth J. Gergen, professor of psychology at Swarthmore College, in Pennsylvania, who is among the principal representatives of social constructionism in the field of psychology, described this new domain on the occasion of a recent encounter.

In his eyes, meanings, like the sense of self and the emotions, arise from an intrinsically relational context: not only do the “I” and the “you” manifest themselves within the dialogues that human relations make possible, but identity itself is produced by the narratives issuing from shared exchanges, which indeed refers the narratives of the self back to social relations rather than to individual choices (III); from this standpoint, even emotions correspond to modes of social functioning, for they are inserted into shared sequences and scenarios.

Gergen proposes that therapists replace the mechanical metaphors of cybernetics with metaphors borrowed from literary theory or from postmodern anthropology: he resolutely situates social constructionism in the postmodern era, defining modernism as a world-view rooted in the sixteenth and seventeenth centuries.

According to this author, modernism assimilated the world to a gigantic machine that human beings had to and could understand, in the hope that understanding the working of this machine would produce knowledge guaranteeing an unlimited progress: so that modern thought laid the accent on projects, evolution, objectivity and rationality. Whereas postmodern thought is said to have been born towards the end of the 1960s, at the same time as the calling into question of an amoral political order, concerned solely with accumulating more wealth and more power; the postmodern approach consequently associates the ethical claim with the deconstruction of the concepts of rationality, objectivity and progress.

In his book entitled Realities and Relationships, Kenneth Gergen analysed the relations formed between constructivism and social constructionism: both conceiving knowledge as a construction of the mind, and both refusing to define knowledge as the faithful reflection of a reality or of a world independent of us (a conception characteristic of modernism), these two approaches reject the subject/object dualism. But for the constructionists, concepts such as “the world” or “the mind” do not have the ontological status that the constructivists seem to attribute to them, for they belong to discursive practices and are therefore liable to be discussed and negotiated in language. According to Gergen, constructivism remains tied to the Western tradition of individualism, inasmuch as it describes the construction of knowledge on the basis of processes intrinsic to the individual, whereas social constructionism, on the contrary, seeks to trace the sources of human action back to social relations. It is in this sense that he asserts: “the construction of the world is not located inside the mind of the observer, but rather inside different forms of relationship”. The consequences of this approach for psychotherapy could be the following, according to Gergen:

• the verbal exchanges between therapist and patient do not reflect any truth whatever; it is not a matter of verifying or applying a preconceived theory, but of engaging in a potentially productive dialogue;
• when the patient speaks of this or that problem, it is important to question the relational context, by asking to whom he addresses this discourse and to what end. The evocation of a depression, for example, may be a way of joining others, of inviting other people to enter into certain specific “dances”;
• meanings being co-generated by the patient and the therapist in the therapeutic context, there no longer exists a single voice, any more than there exists a unified self: there is not one voice but several, and it then falls to the therapist, starting from the pragmatic aspect of therapeutic language, to help the patient bring forth in himself other voices that allow him to turn towards other forms of “conversation”.

Those who converse

Many schools have echoed these latest developments. Harry Goolishian and Harlene Anderson (12), holding that lived experience is understood and experienced through socially constructed narrative realities, came out in favour of therapies centred on the “dissolving” of the problem (dissolving therapies), as opposed to solving therapies, centred on the symptom.

For these two authors, therapeutic intervention is an obsolete principle: the therapist no longer intervenes, he confines himself to taking part in the therapeutic conversation from a “position of perplexity”.

For Michael White, a family therapist practising in Adelaide, Australia, the therapist, taking inspiration from Derrida, must seek to reconstruct the “truths” that have been separated from the conditions and the contexts of their production. Thinking in the wake of Michel Foucault, for whom domains of knowledge are domains of power, White subscribes to the Foucauldian definition of exclusion as a consequence of the acceptance of a socially attributed identity: for persons as for groups, it would be the identity imposed on the marginalised individual that creates exclusion, more than non-belonging to this or that collectivity. Recovering, moreover, the antipsychiatric intuitions of the 1960s, he holds that it is fundamental to unveil the “political nature” of local interactions and therefore strives to externalise internalised discourses by means of “therapeutic conversations”, which aim to “repoliticise” what had been depoliticised. Very attentive, lastly, to the importance of “stories” in the construction of the meanings of individual experiences, he considers that cultural knowledges may end up constituting a factor of “subjectivation”; it is therefore for him in the space created in therapy by the externalisation of some of these internalised discourses, in the new distance the person tends to establish with “her stories”, that alternative narratives may possibly be built.

Although White at one point defined himself as a “radical constructivist”, and although he praised both the structuralists (for whom behaviours reflect the structure of the mind) and the functionalists (who focus rather on the function that behaviour has to fulfil in a given system), his school belongs above all to the movement of social constructionism.

Like Anderson and Goolishian, Steve de Shazer, of the Brief Family Therapy Center in Milwaukee, in the United States, thinks that problems are inscribed in language; but, unlike these authors, he sets himself as his principal objective the resolution of his patients’ difficulties as quickly as possible: far less interested in the cause of problems than in the discovery of solutions, he applies himself to promoting these resolutions by amplifying the latent resources of the people who have sought his help, in accordance with Erickson’s method. He also looks for the “exceptions”, for he is convinced that reality is constructed rather than discovered: with Insoo Kim Berg, he strives to identify the moments when his clients have relatively well overcome the problems they complain of, in order to help them better to struggle against what oppresses them. This approach, centred on solutions, is developing rapidly in the United States, as is attested by the many works recently published by the representatives of this current: In Search of Solutions: A New Direction in Psychotherapy (9), by William Hudson O’Hanlon and Michele Weiner-Davis; Becoming Solution-Focused in Brief Therapy, by John L. Walter and Jane E. Peller; or again Solution Talk: Hosting Therapeutic Conversations, by Ben Furman and Tapani Ahola.

Tom Andersen, professor of social psychiatry at the university of Tromsø, in Norway, began to experiment with the device called the “reflecting team” in the middle of the 1980s (10): in this type of device, the team working behind the one-way mirror reflects aloud in the presence of the consulting family, which then communicates to the therapists the reflections these comments have aroused. This approach, which aspires to develop respect towards the patient, as opposed to the overly hierarchical orientation of certain systemic psychotherapies, has inspired many practitioners, such as Esther Wanschura, of the Institute for Systemic Study and Intervention in Vienna, or Elida Romano, Jean-Clair Bouley, Patrick Chaltiel, Didier Destal, Serge Hefez and Françoise Rougeul, members of the Association parisienne de recherche et de travail avec les familles (APRTF). After having been very close to Mara Selvini Palazzoli, these six therapists turned in a second phase to Maurizio Andolfi’s model of “provocative intervention” and to Carlos Sluzki’s conversational and constructivist model; also receptive to my concept of resonance, they have furthermore created small training groups in which each student is free to experiment with a specific style of intervention. These multiple references are a trait common to most training schools: training in a single approach is indeed relatively rare in Europe. But the richness of the APRTF is further amplified by the belonging of its trainers to an institutional psychiatric system within which they have developed numerous family psychotherapy units.

Those who question

In a context where dialogue tends more and more to be preferred to “intervention” for modifying meanings and widening the field of possible alternatives, the therapeutic importance of “questions” can only increase: this notion has been taken into account by Luigi Boscolo, Gianfranco Cecchin, Karl Tomm, Carlos Sluzki, Peggy Penn, Lynn Hoffman and many others, who have stressed that questions could be powerful instruments of self-healing.

It is interesting to note how certain family therapists were led to move away from constructivism in order to turn towards social constructionism. Lynn Hoffman and Harlene Anderson have recounted the way in which Harold Goolishian parted from constructivism as early as the end of the 1980s: this separation occurred, according to them, in the village of Sulitjelma (Norway), where Tom Andersen had organised an encounter in which there took part, among others, Ernst von Glasersfeld, Heinz von Foerster, Humberto Maturana, Lynn Hoffman, Harold Goolishian, Harlene Anderson, Gianfranco Cecchin and Luigi Boscolo. Anderson and Goolishian had shown the theoreticians a video intended to give them a concrete example of their non-directive style; not only did their work appear to have been little understood, but some members of the audience proved resolutely refractory to their demonstration. Shortly afterwards, at the moment when Lynn Hoffman could no longer follow a debate between two constructivist theoreticians, Harold Goolishian came up to her to announce that a “click” had just occurred in his mind: he had just understood that cybernetics was not a science of understanding, but a kind of energy founded on control, and he said he was convinced of the necessity of henceforth renouncing analogies of a cybernetic type. In the course of the conversation in which Lynn Hoffman informed me of this fact, Harlene Anderson made it clear that at that time Goolishian and she herself were studying Kenneth Gergen as well as the constructivist authors: they were until then striving to make these two theoretical corpora coexist as complementary references, and it is only from that encounter at Sulitjelma onwards that they parted from the constructivist movement in order to take an interest in social constructionism, in hermeneutics and in the theories of narrative.

Collaborative therapy

On the occasion of a seminar they led in November 1994 in Chicago, within the framework of the fifty-second congress of the American Association for Marriage and Family Therapy, Joan Aderman, Tom Andersen, Harlene Anderson, Marilyn Frankfurt, Peggy Penn, Tom Russell and Kathy Weingarten circulated a text setting out the essential points of the approach they advocate: called collaborative therapy and intended as a co-construction of the new linked to postmodernism, this approach opposes social systems defined by structures and roles to linguistic systems – families, individuals living in language –, and hierarchical organisations to horizontal and egalitarian ones. For the partisans of this collaborative therapy, the self is a multiple agency that merges into language and relations, while the therapist’s “not-knowing” is considered indispensable to the emergence of new possibilities. Conceiving therapy as a collaboration between two persons having different experiences and perspectives, rather than as a collaboration between an expert and subjects who ask for help, this group logically deduced from it that the therapist must accept to settle into a “not-knowing” in order to open himself to the possibilities that knowledge would put in peril. This position, which makes it possible to remain within a process of learning, gives priority to the joint search of therapist and client, without thereby implying the rejection of all prior knowledge.