Therapist: Are you sure, Marcie? How do you know that she knows that you're concerned about her?

When was the last time that you told her?

Marcie: Look, things like that don't need to be said; after all, I'm her mother; I mean . . . (fading out)

Therapist: Well, just go ahead and try it, Marcie; you know, being her mother and all.

Marcie: Margaret, I . . . (pause) . . . (Marcie laughs nervously) . . . this is really hard. I don't see what. .. OK (laugh), I am concerned about you, Margaret. I care about you and what you are doing.

Therapist: (turning to Margaret) Well, Margaret, did you hear what she said?

Margaret: Yeah, I heard . . . but it's blowing my mind . . . and I like it.

Therapist: Margaret, is there anything that you would like to say to Marcie?

Margaret: Oh, oh ... , mmm, let me see ... well, actually, I do want to tell you that your face looked so nice and soft when you just said what you did. I mean, ... I really liked watching you and hearing what you said, and any time you want to say anything like that again, I'll be glad to listen.

Therapist: Marcie (turning to her), did you hear her? (pointing to Margaret)

Marcie: (crying softly) Yes, I did.

Here, the therapist begins by identifying the by-now-familiar pattern of Mind Reading. He challenges the calibrated feedback by asking the mother to check with her daughter to find out whether or not her hallucination is accurate. Marcie immediately balks. This notifies the therapist at once that a family rule is involved — specifically, the rule that, in this family, the expression of concern by the mother for the daughter (and, in our experience, this rule probably applies to other members of the family as well) cannot be explicitly communicated verbally. In other words, in the terms which we have been developing, the rule eliminates the output channel of verbal expression for messages of concern.

The therapist stays with Marcie, encouraging her until she successfully breaks the family rule against expressing concern through bodily contact. As soon as the mother has accomplished this, he moves to the daughter and works with her to provide positive feedback to Marcie. Then, he extends this new learning, the ability to use the output channel of direct verbal expression to communicate concern, and has the daughter break the rule, also. Next, he creates another option for expressing messages of love and concern within the family system. He guesses at and then verifies that there is a rule against the mother and daughter (and, most probably, the other family members) expressing their love and concern physically — that is, he identifies another output channel which has been knocked out by a rule.

Therapist: I have a hunch about something. Marcie, is there any way that you can imagine that you could, right now, express your concern for Margaret?

Marcie: Huh, I don't see how . . . , I . . . no . .. I can't.

Therapist: Well, are you willing to learn another way of expressing your concern for Margaret?

Marcie: Sure, I'm game. I sorta like what I've learned so far.

Therapist: Marcie, I would like you to slowly get up, cross over to Margaret, and hold her gently.

Marcie: What? That's silly; things like that ... oh, that's what I said the last time, (getting up and crossing the room to Margaret and slowly, at first clumsily, and then more gracefully, embracing her)

Therapist: (quietly turning to Tim) And, Tim, what are you aware of as you watch this?

Tim: (startled) Ahh, I want some, too.

This is an excellent example of the outcome of a therapeutic intervention to assist the family members in congruently expressing their feelings and caring for each other. The therapist assists the members of the family in becoming congruent in the expression of important messages. As this happens, he immediately generalizes this new learning to include other output channels — other choices for harmonious expressions — and other family members.

SUMMARY

In Part I, we have attempted to begin to develop a model of the ways in which we have found it useful to organize our experience in family therapy. We have done this by, first, attempting to find a point of common experience from which to build our model. This point of common experience is a description here in words which each of you can associate with the actual rich and complex experiences you have had in your work as family therapists. As we stated previously, models of experience — our model of family therapy — are to be judged as useful or not useful, not as true or false, accurate or inaccurate. The first requirement for a model to be useful is that you must be able to connect it with your experience — thus, the need for a common reference point. We have selected language patterns as the common reference point; these constitute the Patterns of Family Therapy, Level I.

The second level of patterns which we have identified involve non-verbal as well as verbal patterns. We have not attempted to be exhaustive — there are many more patterns of which we are aware which we have found to be extremely useful in our work in family therapy. Rather, we have attempted to identify the minimum set of patterns which we feel necessary for creative, dynamic and effective family therapy. In the next part, Part II, we will group these patterns into natural classes and specify some of the ways in which we fit them together in effective, larger level patterning. We will also, in this next part, focus more on the choices which the family therapist has in assisting the family members to change the patterns of their system to make possible the process of change and growth, both for each of them as individuals and for the family as a whole.

PART II

Introduction

In this part of the book, we will present the overall model for family therapy. Models for complex behavior are ways of explicitly organizing your experience for acting effectively in this area. Family therapy is assuredly one of the most complex areas of human behavior. For our model to be useful for each of us as a family therapist, it must reduce the complexity to a level which we, as humans, are able to handle. In the model we present here, we have kept that requirement clearly in mind; we have identified what we consider the minimum distinctions which will allow the therapist to organize his experience in family therapy so that he may act in a way which will be both effective and creative. What this means is that, in our experience, when we are careful to make the distinctions we present in our model, and when we organize our experience in the category specified in the model in the sequence stated, we have been consistently effective and dynamic in our work with families.

In Part I of this book, we identified and gave examples of some of the patterns we consider necessary for effective family therapy. In this portion of the book, we group those patterns into natural classes. These natural classes specify a sequence in which the therapist can, in our experience, usefully employ those first-level patterns — they show him an order in which he may effectively apply the patterns identified in Part I. The result of this grouping is an explicit, formal strategy for family therapy. The strategy is explicit in that it specifies both the parts of the process of family therapy (the patterns of Part I) and the sequence in which they can be applied. Because it is explicit, the strategy is also learnable. The strategy is formal in that it is independent of content — it applies equally well to any family therapy session, regardless of the actual "problems" which the family brings to the session. Again, we are stressing that there is a process independent of content. Our attention is basically on the process. Change the process and new uses of content are possible. The process depends only upon the forms and sequences of the patterns which occur in the communication between the family members and the therapist. For example, the process is independent of the length of the therapeutic session. Another way to explain what we mean when we point out that the strategy given by our model is formal, is to say that the model deals with process — it focuses on the patterns of coping within the family system, irrespective of the specific problems found within that family.


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