A double referent

The title of this brief note has a double referent. In the first place it points to the book that sums up the dialogue conducted by Olga Silverstein and Bradford Keeney, an exquisite clinician and a refined theoretician, entitled The Therapeutic Voice of Olga Silverstein (1986). That work unfolded throughout a training course given by both of them at the Ackerman Institute, and later crystallised in this book.

In the second place, it refers to Olga Silverstein’s clinical voice in the field of family therapy. The book is unique in that it is the complete study of a case of Olga Silverstein’s and in that it presents a permanent interaction between the theoretical maps and the clinical material, thereby making conceptual understanding possible. It is the first in a series edited by Keeney, entitled “The Art of Systemic Therapy”, intended to foster a creative relationship between systemic ideas and clinical practice. The structure of the book and of the series combines a theoretical introduction followed by the presentation of the clinical material, enriched with commentaries as the case advances; it makes it possible to structure a dialogue isomorphic to the one therapists carry on with themselves while they work.

The commentaries include clinical strategies and a parallel conceptualisation, intended to give an understanding of the therapeutic process.

The aim of this dialogue is to understand and to explain how systemic therapy is constructed.

Olga Silverstein and Bradford Keeney

I shall begin by briefly introducing Olga Silverstein and Bradford Keeney. Olga Silverstein is a many-sided figure: family therapist, teacher at the Ackerman Institute for Family Therapy in New York, director of the Brief Therapy Project (whose team included therapists such as Joel Bergman, Richard Evans, Lynn Hoffman and others), director of training programmes. With Peggy Papp, Elizabeth Carter and Marianne Walters, she founded the Women’s Project in Family Therapy¹. Her clinical work has been praised by leading figures in family therapy belonging to different schools.

Bradford Keeney is an epistemologist and a cyberneticist in the field of family therapy. He is director of the Family Therapy Research Project of the Department of Human Development and Family Studies at the University of Texas, and co-director of the Cybernetics Project for Human Systems.

Three epistemological distinctions

In the model Silverstein and Keeney propose, the description of interventions involves a first basic epistemological distinction between the domains of observation and the position of the observer, both of which are in turn discriminated by a second distinction between semantic and political frames of reference.

The domains of observation are distinguished according to whether they are constructed by a participant in the conversation, by an observer of the conversation, or by the participant observing their own participation. This distinction applies to the different domains contained in one and the same therapeutic process in which therapy is done with a team on the other side of the mirror, as well as to the therapist’s interventions and to the messages the team sends to the family.

In the second distinction, the therapist’s frames of reference are differentiated into semantic and political. The semantic frame refers to the meaning that the information has for the family; the political frame emphasises the sociopolitical organisation of the problem within the family.

“Systemic therapy, in a few words, involves envisioning the semantic frame presented by the family and the therapist as a metaphor about the problem situation…” (Keeney, 1986, p. 9). “The art of systemic therapy consists in particular in using semantic and political frames of reference, as well as constructions that propose realities which facilitate change” (Keeney, 1986, p. 180).

Olga Silverstein works with a general hypothesis about the politics of the family, which consists in understanding that an individual’s problem behaviour has advantages and disadvantages for each of the members who make it up.

These frames of reference serve to contextualise the descriptions that arise from any domain of observation.

A third distinction is the one drawn between formal understanding and practical strategy, and which is called the domain of intent: in this context, interactions that aim at the merely formal register are thus differentiated from those that aim at a practical strategy. With regard to the domain of intent, particular emphasis is placed on the fact that therapists working with a team should have a code equivalent to light signals, making it possible to specify which domain of intent they are moving in.

In short, each of these three great distinctions organises a different epistemological field:

A constructivist position

Olga Silverstein adheres to a constructivist position in family therapy and stresses that, when the therapist and the family are joined in producing a new construction of reality, the semantic and political frames are reframed and used to sustain that process. She puts forward the idea that, by taking part in this new reality, the members of the family place themselves in a different position, of a higher order, which will allow them to handle both current problem behaviours and those that will arise in the future more effectively. These co-constructions issuing from the therapeutic process come to be part of the family’s new reality.

In her clinical work there is an impeccable care of the focus of attention. In the course of therapy, Olga Silverstein selects a few central themes, for which she ranks data from the family’s interaction, generating new complementarities that gradually organise themselves around the political and semantic frames.

In this process, she carefully underlines the data that tend to confirm the hypotheses shared with the members of the family, not listening to those that would add nothing to this new dialectic being proposed.

Starting from a constructivist conception, Olga Silverstein and Bradford Keeney stress that: “Instead of offering cures or solutions, systemic therapy offers an alternative reality that is constructed and that transforms the meanings and the politics of the members who are part of the therapeutic system, including the therapeutic team…” (Keeney, 1986, p. 184). “This approach suggests a different epistemological understanding of what we see as problems or as solutions. For a systemic therapist there are no real problems. There are constructed problems, which have had constructed consequences. In the same way, the solution to the problem is a construction” (Keeney, 1986, p. 185).

What feminism changed in her clinical work

As a member of the Women’s Project, O. Silverstein puts it this way: “… feminism has forced many therapists to rethink their assumptions…”, “… today I do a very different therapy from the one I would have done ten years ago…”. “The implicit assumption held by a good many approaches – that mothers are intrusive, make people ill, are withholding, infantilising, and so on, and that the aim of many therapies would be to help children to be able to move away from their influence – has been very widely spread in our culture. Even the mockery, in novels and plays such as Portnoy’s Complaint and Generation of Vipers, by Philip Wylie, whose central theme is that mothers are to blame for everything, is part of everyday language…”

Speaking of the change that the reflections of the feminists produced in her, she says: “I know that I now do another kind of therapy. In a case where a mother and a daughter are caught up in a problem in the relationship between them, I would have seen the aim of therapy as helping the daughter to separate from her mother; today my approach is based on fostering the psychological growth of both women by helping them to maintain and enrich the bond between them” (Silverstein, 1985, p. 72).