Fractioned Totality
Abstract
Contained within these pages are the varying components of my approach to therapeutic work. These consist of my personal orientation to therapy, human beings, problems, and change, which are systems theory, postmodernism, social constructionism, and narrative therapy. Addressed are explanations of how these concepts relate to my view of problem formation and their implications for change in a therapeutic setting. Themes discussed are the limitations of perception and language, the postmodern notion of no absolute truth, and its relation to notions of normality. Following a description of these ideas is an application of what this means for clients in therapy and the relationship I hold to them, their problems, and change in therapy.
Keywords: systems theory, postmodernism, social constructionism, narrative therapy, normality, perception, epistemology, therapy
Fractioned Totality
As a systemic oriented therapist, I find it hard to begin writing this paper, because I acknowledge, to the best of my ability, the vast totality of these ideas. I recognize the limitations of using language as a way to simplify ideas through description, which makes it difficult to choose which words will best describe my orientation to therapy. I know no words will ever fully or accurately describe my thoughts, but I will choose the ones I feel best explain these concepts from my perspective at this time. To do this I must account for how my own systemic epistemology shapes the way I view individuals, families and problems. I will note the underpinnings of my epistemology, which include systems theory, postmodernism, social constructionism, and narrative therapy, and explain how these relate to my views on the process of therapy. I will then describe other important considerations in therapy such as utilizing research, and acknowledging relational ethics and diversity within Marriage and Family Therapy work.
Personal Epistemology – No Fault
When thinking of human beings from a systemic perspective, I do not find anyone to be flawed, abnormal or even normal for that matter. As system theory acknowledges, we all exist in relationship to many different systems in our lives, which influence our thoughts, beliefs and behaviors (Bateson, 1972). Our interconnected state in relationship to these systems makes up the context of any problem. This makes it inaccurate to assume problems reside within one individual (Bateson, 1972). No one can strictly be good or bad or fully at fault because we all exist as a product of our patterns of relating (Keeney, 1983).
No Truth
Since I also hold a postmodern therapeutic orientation, it is important to acknowledge how perception plays a role in all situations. We are all limited by our own interpretations and punctuation of the world, based on the distinctions we draw, so we can never fully claim to know what the real reality is (Keeney, 1983). This means no one perception is more true or valid than another. From a social constructionist standpoint, Truth is not something that can be decided on or known (Gergen, 2015). This view embodies the postmodern critique to modernist notions of an objective and fixed reality (Anderson, 1997). Social constructionism challenges these notions by acknowledging that reality, knowledge and meaning are simply a social phenomenon. (Gergen, 2010).
It is through our conversations with others that we decide to attribute meanings to certain things. Since the context of social agreement widely varies depending on the location, ideas and values of a certain group making those decisions, there cannot be one single truth. This was another critique of postmodernism which pointed out that only select groups were making claims of objective truth based on their positioning in a system of power. This level of authority was not widely distributed, thus many voices were not recognized or included in creating the meaning system of “how the world is.” We can refer to these limited notions of truth as dominant narratives due to their taking precedence over other minority opinions (Gergen, 2015).
As explained above, just by nature of relating to others we create our own definitions of accepted ways of being in the world. These definitions however, do not fully encompass the spectrum of difference one may encounter. Whenever something deviates from our own understanding of what is a common experience, it becomes easy to assume there is something wrong. After all, our established norm includes all the information we have already filtered into it, and if something does not seem to fit, it makes it harder for us to accept and interpret (Jackson, 1967). However, as Gergen (2015) states “If we understand that our claims to what is real, true, or moral are human constructions, born within culture and history, then we might be more tolerant and curious about those from whom we differ.” (p.3). Thus, those who differ just exist outside of a certain social convention, but could just as easily fit into another if it were available (Gergen, 2015).
No Normal
Adopting these beliefs means everything is debatable in a sense. I do not believe in any form of “normality” outside of pre-established meaning systems. As I have mentioned above, any established meaning system will inevitably fall short in accurately capturing the totality of things. Jackson (1967) states, “Genetic theories about what is normal and what is not normal rely on the assumption of “thingness” of pathology, labeling human traits or characteristics as if they were tangible realities when in fact, such “traits” are only ideals and remain undefined and unobserved in any scientific sense.”(p. 35). As humans, we need labels to simplify and categorize our experiences, so it makes sense that we use language to define our lives. As Jackson (1967) explains, “This kind of classification is part of our attempt to simplify life and build reassuring fences around the perimeters of experience. The more common the experience, the more comfortable it makes us: it is easy to classify and can thus be called a known fact.” (p. 120).
This attempt at simplification is recognizable in our use of language, and has its own set of ramifications. Unfortunately, we can only define individuals and their behaviors based on the language available (Anderson, 1996). As Anderson (1996) explains, whenever we describe someone a certain way, we leave no room for them to deviate from this description. However, no person is static and no definition can fully encompass anyone or anything. It becomes easy to believe these definitions of commonality and normality are static, and unchangeable which can often be what leads to problems for clients.
No Limits
Approaching therapy from a narrative perspective, I do acknowledge how clients form their own stories about themselves based on the experiences, influences and language available to them (Freedman and Combs, 1996). It is important to recognize the ways in which these descriptions of clients and the events in their lives can actually remain flexible. Together we can deconstruct the dominant narratives, which shape the understanding of their lives and expand these exclusive definitions (Freedman and Combs, 1996). Now that I have discussed my personal approach to therapy, I will move on to how I believe problems are often formed.
Problem Formation – Lost Touch
I believe perception plays an important role in problems arising in clients’ lives. I will now discuss some scenarios related to this assumption. One common example being when clients show up to therapy perceiving they have deviated from some norm in their lives (Watzlawick, 1974). Even though a true norm does not exist, clients have often formed ideas about what is and is not acceptable which help them shape their lives (Besley, 2010).They might compare where they are to where they were if a previous version of themselves was more acceptable in their eyes. They might also feel a sense of inadequacy in comparison to more widely established social norms. The former is a result of clients holding themselves to static notions and not acknowledging how they or their circumstances may have changed. The latter being a result of attempting to live by someone else’s rules (Besley, 2010). The problem becomes how they are relating to both themselves and the larger society. When we try to live by certain defined expectations and fail because of varying factors, we are not acknowledging how we have chosen to abide by the predetermined stories or our ability to reject notions that no longer serve us.
For example, a recent client of mine described how she feels she used to be strong, but now she is not. She explained how sadness kept piling up and her strong persona finally broke down one day. Now she feels as if the sadness prevents her from being strong so she has to hide it at all costs. She thinks if she does her best to project that stronger self to everyone, they will perceive her as the strong person she values. Thus, she is stuck trying to reinsert herself into an outdated role based on how she feels others should perceive her.
Lost for Words
Another form of perception playing a role in clients’ issues is when they are simplified by someone else’s perceptions. As a postmodern therapist, it is crucial to recognize how any descriptions are inevitably limited, and how the use of labels can distance us from the fully encompassing view of a person (Anderson, 1996). We are attempting to measure something immeasurable, because people are complex and comprised of systems upon systems (Anderson, 1996). Labels can restrict a person’s ability to change, which is almost counterintuitive to the expectations of the therapy process. Anderson (2007) explains, “Different kinds of language – for example, the language of competition, the language of strategic management, the language of pathology, and so on – all have their consequences, both for those who are described and for those who describe.” (p. 90).
For example, one of my clients positioned herself as a patient of bariatric surgery. To her doctor she was just that, another statistic he must treat with rigid expectations for progress. We had many conversations about how her doctor was failing to consider her greater context in the treatment process. She often felt disappointment when comparing herself to other bariatric surgery patients deemed more “successful” in the recovery process. This left her feeling trapped and minimized by her doctor’s descriptions of her, which also left her doctor unable to achieve his desired results due to his unwillingness to consider the whole context of her experience.
Lost in Translation
Much of problem creation can also be a result of differing perceptions between relating members. In order to claim our perceptions, we must first decide what distinctions we want to draw, which in turn create our given punctuation of the world. (Keeney, 1983, p. 25). Punctuation refers to which elements of our experience we choose to emphasize alongside those we choose to deemphasize. Often times, those punctuations widely differ between individuals. Watzlawick, Weakland, and Fisch (1974) claim “Discrepancies in the way the participants in an interaction “punctuate” the sequence of events can become the cause of serious conflict.” (p. 17). We all filter the world through our own relative experiences, which is unavoidable, and comes with limits. Problems arise when we fail to acknowledge this, and we attempt to judge others according to our limited view of the world. The issue becomes a disagreement about which is the right way to punctuate experiences.
For example, I had a teenage client who was in disagreement with her mom about the meaning behind the use of her phone in the presence of others. The mom expressed that her being on the phone was not a problem as long as she was out spending time with everyone. However, the daughter claimed she felt it was rude to be on the phone around people, and would go off to herself to avoid appearing rude. The mother explained how it felt ruder for her to do this, because she was choosing to spend time away from everyone when she could at least be in the same room. Neither could agree with each other about their perceptions of using the phone, resulting in discord between them.
Facilitating Change - Finding a Preference
I hold the postmodernist belief that there is no absolute truth, therefore this opens up a myriad of possibilities for the people who come to therapy hoping for change. If there are no absolutes when it comes to defining clients’ lives, they can decide on their own preferred realities. This gives the therapist and client the leeway to co-create a new understanding of the client’s so called problems. From the stance of a narrative therapist, using a narrative metaphor acknowledges how the client’s story could be negotiable through applying a different description of events (White & Epston, 1990). We can build on this metaphor to help clients tell themselves more empowering stories by uncovering the unhelpful influences of dominant narratives, and highlighting less emphasized details that reframe their experience. Through this process, the therapist and client co-construct an alternative story with a wider range of possibilities than had previously seemed possible (White, 2011). In summary, narrative therapists’ goal is to help clients claim ownership over their stories so they can edit out any unhelpful details of their experience.
In approaching change in the first case I presented about the girl feeling tied to a former version of herself, I would first attempt to unpack the meaning systems associated with her concept of strong and this former self. I would want to learn how she understands being strong and why it is so important for her. I would also want to know what was different about that time of her life, which allowed her to perceive herself as stronger. Working in this way would allow me to gain the necessary context for how she has formed her personal story. In gaining this understanding, I could begin to challenge any unhelpful notions, which make her feel confined to that limited identity.
I did learn whenever she spoke to her mom about her sadness she would tell her all the bad was meant to make her stronger in the future. This implies to me a learned emphasis on being strong, and the daughter interpreted this as another reason she should not feel the way she does. This also puts her in a position of not feeling able to be strong now since her mom says she will be in the future. I also learned that she perceived herself as stronger before because now everyone constantly checks up on her. While the intent of everyone is most likely to be helpful, it communicates to her she must not be very capable if everyone is so worried about her. Knowing this I would attempt to reframe what it means to be checked on, and search for times when maybe she felt strong even without putting up a front. Highlighting those could give her permission to deviate from her expected norm. I would also want to build on the ways in which she is already strong now. Together we could restructure her narrative in a way that provided more possibilities for her than her original problem narrative.
Finding a Fit
For the second client I mentioned whom her doctor overly simplified as a patient of bariatric surgery, my co-therapist and I worked with her to help her acknowledge that her position in the recovery process made perfect sense for her as an elderly disabled recipient of the surgery. We highlighted her deep self-awareness, and validated her in varying from the general picture of recovery. Through our work together, she was able to be gentler with herself and more vocal to her doctor about her specific needs. She no longer felt the overwhelming guilt she had felt in the past for not “measuring up,” and began seeking out other resources more fitting to her needs. This is an example of how clients are actually so much more than a single perception or label, and could benefit from a more expanded view. As (Watzlawick,1996) explains, “therapy becomes the art of replacing a reality construction that no longer “fits” with another, better-fitting one.” (p. 68). Someone else’s limited construct of who she was stopped being useful so she was able to restructure the way she related to herself in a more beneficial way.
Finding Common Ground
In the case of the mom and daughter disagreement, I would begin by exploring each of their motives behind their actions together. I would want to help them uncover what has led to their own opinions about the issue, and let them both hear they both have good intentions behind their actions. Shotter (1993) explains the importance of this type of dialogue in that “we bring out the nature of what we do, our practices by comparison with what others (actual or invented) do, or don’t do” (p. 61). In discovering how they both are justified by their opinions, they can reach a new understanding in relation to each other. They can feel relieved of any guilt or blame in the misunderstanding, and see it is simply an outcome of their relating pattern (Gergen, 2001). In this particular case, however, the daughter was not willing to accept the mother’s point of view or work on their relationship. There is a dominant narrative regarding blame in society, which makes it easier to respond to conflicts between relating members by placing full responsibility on one person. This narrative does not acknowledge the joint process of meaning making in interactions (Gergen, 2001). I suspect the daughter’s reasoning for declining change was because she could not compromise her own point of view or acknowledge her influence within the dynamics of their relationship. My co-therapist and I allowed her to have her preference.
Research – Not Knowing
When it comes to all clients, I take a not knowing stance because I believe clients are the experts of their own lives (Anderson, 2012). It is not my job to make assumptions about them or tell them how to live, but to hold space for them to discover what they hope to in therapy. That said I recognize my potential need to inform myself when necessary to help fill the gaps in my experience. I must always remain open to new knowledge, and be as informed as I can to be most helpful to clients. However, I must also be careful not to allow any form of research to become the end all be all of any given context. I should never use research as an authoritative guide to working with anyone in therapy, but I do recognize the value of sharing and considering ideas from other contexts and practicing therapists.
Relational Ethics – Not Assuming
It is important for me to acknowledge how holding any epistemology has an impact in the therapy process. Since the distinctions we draw make up our epistemology, I have to recognize the limitations of my own experience. I can only know what I know based on what distinctions I have drawn to inform my punctuation of the world (Keeney, 1983). My epistemology informs the ways I exist in the world, the things I notice and the judgments I make. According to Jackson (1967), “How crazy a person appears to you depends on your own frame of reference and the limits of your own experience.” (p.76). It would be easy to assume that my assumptions about a certain thing were undoubtedly correct, because I have probably had experiences to support these. Examining my own biases is essential to the therapeutic process. It is unrealistic to assume I could be completely objective in my therapeutic work, but remaining aware of this limitation will help me to recognize the ways in which I shape the therapy process. To further assist me in maintaining an ethical practice is the code of ethics established by the American Association of Marriage and Family Therapy (AAMFT). This code contains certain rules set out by the AAMFT to prioritize the welfare of clients (AAMFT, 2015). As a Marriage and Family Therapist, I must always be committed to remaining aware of these and implementing them into my practice.
Diversity – Not Excluding
Diversity is also crucial to my understanding of what it means to be in relationship to the world. I know there is more than just one way to see an issue, a solution, everything in between and anything beyond. I must always acknowledge the vast differences in humans and their experiences depending on their unique context. It is important for me to learn to be inclusive of all types of individuals so there are no limits to whom I can create relationships. As a therapist, I have the responsibility to use the hierarchy of my position in a way that aids clients. This means being willing to discuss my own position in the greater systems at work and in relationship to clients (Watts-Jones, 2010). I want my clients to know that I am willing to meet them where they are and hope they will meet me just the same. I must also recognize the difficulty some clients may have in doing this because I hold certain privileges, and never blame them or feel offended by their decisions. I also respect and follow clients’ preferences when discussing such issues, and do not rely on them to educate me regarding my blind spots. I know it is my responsibility to remain informed about current and evolving diversity matters (Wyatt, 2008).
I have covered an array of topics regarding my own approach to therapeutic practice as a systemic, postmodern, and narrative therapist. I have discussed the basics of systems theory, postmodernism, social construction and narrative therapy, and explained how I relate these concepts to therapy according to my own epistemology. This was by no means an exclusive explanation of these concepts or my approach, because I know they are constantly expanding as well as my own personal practice and understanding of these areas.
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