Family Therapy 19;3 - Wiley Online Library

 The Association for Family Therapy and Systemic Practice 1997. Published by Blackwell Publishers, 108 Cowley Road, Oxford, OX4 1JF, UK and 350 Main Street, Malden, MA 02148, USA. Journal of Family Therapy (1997) 19: 283–302 0163–4445 3.00

Feeling understood in family therapy David Pococka This paper attempts to highlight a common experience, but neglected topic, in family therapy: that of feeling understood. Aspects of postmodernism and contemporary psychoanalysis are revisited to create a theme of understanding as a fully relational activity – making sense together through language of that which lies beyond language. Some ideas on preparing to try to understand are discussed.

Introduction In May 1975, as a young – and not entirely convincing – hippie, I travelled from Istanbul to Tehran on a three-day coach journey. For scores of miles, the land approaching the frontier with Iran was featureless semi-desert and scrub. Most of the passengers stared silently and morosely at the hundreds of burnt-out vehicles strewn along the roadside, caused – it was said – by drivers falling asleep at the wheel and dropping off the steep verges. These skeletal images heightened the anxious anticipation of the border. Arriving at the Turkish post, we joined a tense and chaotic throng of people, many of whom had waited hours in the baking heat for no obvious reason. One tried not to look at the guards – a clichéd machismo of dark green uniforms, black leather and guns, all wearing those impenetrable sunglasses. Several exhausting hours later, on the Iranian side, something surreal was added to this already unnerving experience, in discovering a vast and empty landscape which seemed nearly identical in every detail to that which we had travelled through the previous day. What are borders for and what is being protected? Could it be that the politics of turf are more about preserving identity than territory? Most of us, I think, want to belong. How better than to found a nation, find an enemy and build a fence? I have a theory that each new development in family therapy Principal Family Therapist, Child and Family Consultation Service, Marlborough House, Princess Margaret Hospital, Okus Road, Swindon SN1 4JU, UK. e-mail: [email protected] a

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(used here as a generic term to include systemic practice) requires a ritual attack on psychoanalysis (used here in the American manner to include psychoanalytic psychotherapy). Perhaps this has helped to preserve some coherence in family therapy during a period of many radical shifts which might otherwise have led to fragmentation. It is as if family therapists need to reassure each other: ‘Don’t worry, no matter how much we are different from you, we are, at least, not like them.’ When family therapy invented circularity, psychoanalysis was linear. When relationships were centre stage, psychoanalysis was only concerned with isolated minds. When it discovered meaning, psychoanalysis was a place of certain truth. An interest in strengths required a psychoanalysis preoccupied by deficit and pathology. It is therefore not surprising that family therapy’s current interest in collaboration requires an image of patients racked on the Procrustean couches of their analysts’ mind sets. Gergen and Kaye (1992: 172) provide a not untypical example: psychoanalysts who question the foundations of psychoanalytic theory are placed in professional peril. Under these conditions the client confronts a relatively closed system of understanding. It is not only that the client’s own reality will eventually give way to the therapist’s, but all other interpretations will also be excluded. To the extent that the therapist’s narrative becomes the client’s reality, and his or her options are guided accordingly, life options for the client are severely truncated.

This is not to say that this critique never applies. Psychoanalysis has, for example, to account for forty years when disclosures of child sexual abuse by patients were heard (at least by the psychoanalytic establishment) chiefly as fantasy; and, more recently, it has hardly been enthusiastic about debating accusations of heterosexist bias. But the claim that this is the general – let alone universal – picture is neither supported by research (Holmes and Lindley, 1991) nor by the accounts of those who have been patients (Knight, 1986). The need for psychoanalysis to be a them in order that we can be a more comfortable us dulls curiosity. If we already know, we won’t bother to find out for ourselves. If, as Fish (1993) and Hart (1995) suggest, we use postmodern thinking not just to launch another radical movement in family therapy but also to submit family therapy discourse itself to deconstruction, we may begin to wonder about our subjugation of psychoanalytic ideas; at our unwillingness to consider the advantages – the  1997 The Association for Family Therapy and Systemic Practice

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extra play of différance – that might be available to us and the families we see in holding analytic ideas in mind alongside our more usual ones. In the UK, for example, we may wonder what became of the ideas of Skynner (1987), whose work is now rarely referenced (but with a wide popular audience) or Box et al. (1994), whose work represents one of the few remaining strands in this country of psychoanalytic family therapy. Perhaps, like Coelacanths, we will have to rediscover them in the future and marvel that they were, after all, well enough adapted to survive all that time. In the borderlands of Turkey and Iran there were other activities not legitimized by the dominant politics of identity. One occasionally saw in the distance small groups of dark tents surrounded by a few goats. These nomads had other, more ancient loyalties and needed a different relationship to the territory. One might imagine them crossing the frontier at night well away from the border posts and guards to search out richer grazing. In speaking of the mainstream in family therapy, it is important in this broad analysis not to defer from awareness a story of those who have remained doggedly nomadic; holding on to an interest in both self and system regardless of fashion and continuing to present their syntheses to a sometimes indifferent family therapy community. In a deconstruction of family therapy one might see these as deferred or local knowledges too numerous to list, but – in the UK alone – including Lieberman (1979), Dare (1989), Bentovim and Kinston (1991), Frosh (1991), Kraemer (1994), McCluskey and Bingley Miller (1995) and, perhaps most accessibly, Byng-Hall (1995). Others have strayed into both psychoanalysis and postmodernism but have tended to reject the extreme relativism of some early readings of postmodern thinking (Goldner et al., 1990; Flaskas, 1993; Larner, 1995; Pocock, 1995a). And some of this latter group have brought the therapeutic relationship back into focus (Flaskas, 1996; Speed, 1996). Most recently of all, Flaskas (1997) reveals an unease with the current preoccupation with meanings or stories. Something important – more personal – she suggests, has been left out. If we can suspend our judgements about psychoanalysis and risk entering this domain of bogy persons, we may discover that psychoanalysts and psychoanalytic psychotherapists are more like ourselves than not and, indeed, that some of them have been struggling with many of the same issues.  1997 The Association for Family Therapy and Systemic Practice

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In this paper I want to make short journeys to revisit some aspects of postmodernism and contemporary psychoanalysis. I will argue that family therapy’s dominant stories about these domains have created artificial, unnecessary and unhelpful borders which obscure the possibilities of a deeper appreciation of the concepts of understanding and feeling understood which I believe are central to some contemporary psychoanalytic projects. I suggest that family therapists might be interested in reconsidering these issues because the experience of feeling understood seems to be highly valued by consumers of all therapies, regardless of what their therapists are intending (Reimers and Treacher, 1995). If the experiences of feeling understood and gaining fresh understanding are, as I suspect, very common ones in good-enough family therapy, we should try to make sense of these phenomena. This paper re-explores postmodernism in order to highlight a nonrelativist reading of deconstruction in which language and description are seen, not as constituting reality, but as acting to highlight some meanings at the expense of obscuring others, some of which may be more helpful within the context of the pre-descriptive and ultimately unknowable reality of the family dilemma. Aspects of psychoanalytic object relations theory, self-psychology and intersubjectivity theory are then considered to highlight both the notion of a relational self and the project of a therapeutic collaboration through language to make sense of that which lies beyond language. Ideas for the family therapist preparing to understand are then considered. How important is it to feel understood? What should be a continuing source of discomfort for those advocating particular models of therapy is that there seems, as yet, little evidence that any model produces a better outcome than another despite some bold claims to the contrary. In reviewing thirty years of research evidence, Miller et al. (1995) conclude that it is the similarities rather than the differences between models which account for most of the change.1 Most outcomes seem to be determined not 1 The largest ever survey of the effectiveness of psychotherapies (critically reviewed by Seligman, 1995) supports the lack of evidence for model superiority but adds another important finding: ‘Long-term therapy produced more improvement than short-term therapy. This result was very robust, and held up over all statistical models’ (p. 968).



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by therapy or therapist variables but by the particular balance of strengths, resources and difficulties of the clients. Of the remaining factors measured, they find the therapeutic relationship to be the most significant and about twice as important as issues of technique. This is pertinent in the light of a lengthy period in the recent history of family therapy, when asking the right kind of question (triadic, interventive, future, miracle) seemed to be the prerequisite for success. Despite the allure of technique and the therapeutic marketplace, what seems to count is the strength of the therapeutic alliance with someone whom the recipients of therapy perceive as warm, trustworthy, non-judgemental and empathic. Morrison Dore (1996), in reviewing the strong evidence correlating outcome with alliance, finds that most alliance measures seem to tap key experiences of ‘having someone there for me’, ‘being accepted’ and ‘feeling understood’ in a purposeful collaborative relationship. But how may this result in change? Some suggest that telling one’s story in one’s own terms and having it heard respectfully is sufficient for change to occur. Parry (1991) puts this succinctly: ‘It may yet be realised that Freud’s greatest discovery was not of the unconscious but of the validation that a person receives simply in telling her story to an attentive listener.’ (Note how, in setting out his stall, Parry gives that of psychoanalysis what seems to be the familiar ritual shove.) Careful listening (Andersen, 1987; Hoffman, 1993) is a relatively new theme in family therapy – although an ancient one in psychoanalysis – and there is much to be welcomed in this development. A listening therapist helps to create a space for thinking in the family (Box et al., 1994) and may slow things down sufficiently for family members to really begin to hear each other. The possibilities for family members to risk revealing more of themselves in this respectful space may be a rich source of new ideas and may itself be sufficient for change to occur. Understanding as a collaborative process is a core idea in social constructionism. Meaning and understanding are a matter of negotiation between the participants in the conversation. But the assumption that language constitutes reality restricts the therapist to the role of skillfully elaborating the experiences and meanings of family members. The ideal is the not-knowing therapist who explores the narrative coherence of all those present but takes care not to influence it with assumptions drawn from other therapeutic  1997 The Association for Family Therapy and Systemic Practice

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paradigms.2 This idea is contrasted implicitly with the knowing therapist whose aim is to ‘gather information for validating or supporting hypotheses’ (Anderson and Goolishian, 1992). Understanding understanding I believe these images of the knowing therapist – who assumes that language represents reality – and the not-knowing therapist – who assumes that language constitutes reality – present a false dichotomy. There is, I believe, a space between knowing and not-knowing in which a different kind of collaborative understanding is possible. It is this space that I wish to explore below, through revisiting aspects of postmodernism and psychoanalysis. Postmodernism I think it is reasonable to suggest that family therapy is now less comfortable with the concepts of truth and reality than at any time in its history (see, for example, Pocock, 1995a and Flaskas, 1997 for reviews). This discomfort has, I think, been the source of much creative thinking as well as a good deal of confusion. One area of difficulty seems to have arisen out of the failure to properly differentiate between two epistemologies – objectivism and realism. A moderate realism (Orange, 1995) assumes that there is something to be known – some pre-descriptive thinginess than can never be captured or fully described. (Speed (1984, 1991) has been making much the same point for the last thirteen years. Others (Breunlin et al., 1992; Pinsof, 1994; Flaskas, 1994; Frosh, 1995; Larner, 1995; Pocock, 1995a, 1996; Launer, 1996) have increasingly joined in.)) Objectivism is different, insofar that it assumes an observerless description is possible – that knowledge can exist independently of the knower. Objectivism as an epistemological position (what family therapy calls first-order cybernetics) is largely discredited today, but this cannot mean that reality has been abolished. (If you gently bang what we agree to call this journal against what we agree to call your forehead you may see what I mean.) A belief in 2 One way of making sense of this stance is to see it as an enduring reaction against the authoritarian use of theory-as-blueprint in the structural, strategic and early Milan schools. In this social constructionist position, all theory – no matter how tentatively used – is perceived as ultimately malign.



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an ultimately unknowable real seems compatible with much of postmodernism. Fish (1993) is helpful here in describing two readings of a much quoted but ambiguous statement of Derrida: ‘there is nothing outside the text.’ In the first reading, language is seen as constituting reality and there is literally nothing at all beyond language. Fish traces this to an American style of literary deconstruction in which the meaning of the text is seen to be undecidable. He calls this ‘Yale Deconstruction’, and it allows the reader to draw any number of meanings from the text – all equally valid. It is the interpretation of deconstruction which is inextricably linked to extreme relativism. Fish sees this reading in the work of de Shazer (e.g. 1991) and I believe this assumption about language can also be perceived in the work of Anderson and Goolishian (1988), Hoffman (1993), and much other therapy based on social constructionism (Andersen, 1987; McNamee and Gergen, 1992). It is this reading which suggests an atheoretical listening and facilitating position for the therapist. Fish makes it clear that Derrida himself sees this as a misunderstanding of his work. ‘Nothing outside the text’ simply means ‘that one cannot refer to this real except in an interpretative experience’ (Derrida, 1972, quoted in Shawver, 1996). Although language is all we have in describing reality, there is always something beyond language. ‘Text’ may become more understandable within ‘context’ which, for Derrida (1972), ‘does not exclude the world, reality, history’. Not all meanings are equal. This opens up new possibilities for us in considering what there is to be understood. Language and description in this second version can both help and mystify us. They may hypnotize us into believing that our way of seeing things is the only way. One can recognize this, for example, in the descriptions of children who murder as ‘evil’. This word shapes everything about our response to such children and we do not see our part in this attribution. Deconstruction recognizes how the description ‘evil’ puts out of our mind all other ways of thinking about the complex reality of them and their crimes. As John Major said in the context of juvenile crime (and the UK May 1997 election), ‘we should condemn more and understand less.’ Such acts may become more understandable if we bother to be curious – but always imperfectly. Each way of seeing the complexity can tend to defer from awareness other ways of seeing. Derrida collectively calls these other ways ‘différence’.  1997 The Association for Family Therapy and Systemic Practice

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Deconstruction is the method of allowing into awareness these other perspectives – some of which may be closer to that which is ‘really going on’ (Orbach, 1994). In family therapy, the différence may include the patterns of mutual influence not yet thought of, the unappreciated strengths, the unacknowledged injustice, the cultural influences not yet recognized, the parts of the story that remain untold, or the unconscious wish of family members. ‘For différence is the hidden of every story. The trace is the obscured remnant of what is hidden, the unconscious wish or disowned motive, that can sometimes be brought into the presence of consciousness’ (Shawver, 1996: 383). Bateson (1972) also believed in a reality (territory) which always lay beyond perception (map). A change in the map requires the arrival of news of a difference – a fresh idea – about the territory. Derrida’s différence helps us to understand how one idea obscures other, possibly more helpful ones – that the collaborative search for a useful Batesonian difference needs to avoid being bound by the mystifications of language and description. (See Shawver (1996) for a helpful discussion of this non-relativist view of postmodernism in psychotherapy.) The family therapist holding these assumptions about language will not willingly discard any theory or metaphor that may be helpful in the collaborative search for that, which if brought into the presence of thought, may result in change. Any perspective, including those drawn from the languages of psychological theory, may then be revealing or obscuring in this search. Contemporary psychoanalysis Why have some family therapists retained an interest in psychoanalytic ideas when the culture of family therapy has not always been supportive? One (untested) pet theory is that such therapists have a different kind of knowledge about analytic ideas – a knowledge derived from the experience of being patients.3 For anyone who is I recall my own experience in analytic psychotherapy which took place concurrently with much of my family therapy training. During that period constructivism was enjoying a brief dominance and, accordingly, psychoanalysis was seen as rigidly hierarchical, first order and prone to misguided instructive interaction. There was much pleasant confusion in the experience of my analyst tentatively offering some new ideas, following which she would often ask ‘I don’t know whether any of that fits?’ She obviously had the wrong script. 3



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not a patient or ex-patient who has to rely on descriptions from inside family therapy in order to know about psychoanalysis, it may be difficult to appreciate just how much has changed since Freud. (Indeed, it would also be difficult to get any balanced view of Freud’s contribution.) A contemporary vision is not one of taming the unconscious of the isolated individual, in which a seething mass of drives and impulses threaten to get out of hand. Instead, as Holmes (1996) puts it, the unconscious is viewed as ‘an inner representational world, populated by significant others, that acts as a template for intimate relationships and can explain recurrent patterns of relationship difficulty’. The contribution of object relation theories has been in understanding a relational self – a raw material of temperament which is then formed and reshaped through the contingencies of earliest relationships and to some degree – throughout life. Such is the richness of object relationship theories that some family therapists have found these sufficient to move easily between concepts of self and system (see, for example, Scharff and Savege Scharff, 1987; Box et al., 1994) and this, I think, has contributed to the drift away from the preoccupations of more mainstream family therapy discourse. Other major influences on the contemporary scene are the selfpsychology of Kohut (e.g. 1985), which sees a major role for empathy of the therapist in getting close to the experience of the patient to work with narcissistic wounds caused by failures of responsiveness and admiration by early caregivers, and intersubjectivity theory (Stolorow et al., 1994), in which the analytic relationship is viewed as the meeting point between the subjectivities of analyst and patient and in which the former holds a (very second-order sounding) concern to understand from within this system. Themes of relational theory (see also Hart (1996) for a useful synthesis of feminist, psychoanalytic and social constructionist ideas on the relational self), not-knowing, collaboration and intersubjectivity should all be recognizable to the contemporary family therapist. When family therapy makes a straw man of psychoanalysis – a nation state of tyrants, fault-finders and know-it-alls – it leaves out a central, hopeful and humanizing psychoanalytic assumption that people, no matter how crazy, frightened or depressed they feel, may be understandable in the light of their experiences. But the process of understanding, in this contemporary vision, is not that of the  1997 The Association for Family Therapy and Systemic Practice

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patient receiving an accurate interpretation from the analyst which increases cognitive insight. It is a systemic and constructionist process – a making sense together of that which previously seemed unthinkable or incomprehensible. The thinking of two people – analyst and patient – is used primarily to develop understanding of the latter (although many would consider it a poor experience if the analyst were not also changed). Understanding ‘emerges from the work/play of two or more people together. Understanding is a relational way of being and knowing’ (Orange, 1995). Although understanding is always social construction,4 this collaborative project is not restricted by the social constructionist view of language. The not-knowing of the object relation theorist Wilfred Bion does not map exactly on to the not-knowing of most social constructionism. Bion counselled analysts to keep one eye on their assumptions about the patient (tentative knowledges in which theory has played a supportive role) and one eye on that which was not known. The creative tension in this kind of binocular vision is also scary: ‘In every consulting room their ought to be two rather frightened people; the patient and the psychoanalyst. If they are not, one wonders why they are bothering to find out what everyone knows’ (Bion, 1974, quoted in Casement, 1985). I want to specify two ways in which this strand of psychoanalysis may further this enquiry into understanding. First, we may learn from the experiences of the psychoanalysts and psychoanalytic psychotherapists who have managed to inhabit with their patients the difficult middle ground between knowing and not-knowing. Of course, some analysts still claim they can discover the truth and some claim that all knowledge is necessary fiction, but many have avoided this dichotomy in a way that family therapy – with its first/second-order and modern/postmodern splits – has not. (See Orange (1995) for a full discussion of psychoanalytic epistemologies.) This model of understanding is neither atheoretical, nor is it a proving ground for theoretical hypotheses. It uses theory but in a way that serves the therapeutic process rather than dominating it. It should perhaps be stressed that there is nothing inherently analytic about this epistemology. It is a middle ground which seems highly 4 I follow Efran and Clarfield (1992) in their position on social constructionism as a description of what happens in all dialogue rather than a prescription of something special that therapists should do.



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suitable as a basis for synthesis of many of the knowledges in family therapy and systemic practice (Pocock, 1995a, 1995b, 1996). Second, this contemporary position on the relational self may shed light on the relevance of the apparently universally important experience of feeling understood in all therapies. The relational or dialogical view of self suggests something fundamental in the process of a change of understanding in the patient. In this view, the self does not change its mind or revise its story. The self is made up of storied (or internalized) relational and other lived experiences5 which serve as maps in orientating to current relationships and events. Some of these storied experiences are unconscious and, by definition, relatively inaccessible, while some are more accessible. A change in understanding is then a change in coherence of self, which includes relationships to others and to the world. (This appears to be similar to the work of Epston and White (e.g. 1992) in which narrative and self are not separate.) Understanding is always personal. In the intersubjective field of family therapy there may be little to be more understood that does not require at least one person to feel more understood. Feeling understood often seems to be a profound relational experience of discovering that one is more acceptable and comprehensible to the other or others than was originally feared. It is a holding base from which some shift in the coherence of the self may be risked. This idea of change holds up just as well, I think, for family therapy and systemic practice. For Bateson (1972), self and experience were also the same. If we consider the system as combining the coherence of each person – a coherence of coherences (Dell, 1982) – then a change in the self is a change in the system, a change in the system is a change in the self. This psychoanalytic self is the mirror image of the Batesonian self. Our institutionalized boundaries between some current psychoanalytic and family therapy discourses have, I suspect, only the flimsiest of territorial justifications. (I refer here mainly to the languages and cultures of these modalities rather than their practices, some of which, I think, do need to be different.) 5 Shawver (1996), who describes her work as a form of postmodern psychoanalysis, speaks of a dialogical self which is made up of many voices derived from self–other relationships. She defends this concept of the multiply faceted self against criticisms of fragmentation. Instead, she sees the recognition of disavowed relational facets as the route in psychotherapy to greater self-coherence.


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Preparing to try to understand I now want to use these ideas to briefly consider ways in which the experience of feeling understood in family therapy may become more possible. Using theory lightly I believe that one potent spectre which haunts current family therapy discourse is that of the super-osmotic family, ready at a moment’s notice to drop their constructs in favour of those of their therapist. Thankfully, I think the majority of families are tougher and more sensible than this and well able to deflect ideas and approaches that don’t suit them. However, a therapist who is incautious about the use of theory is, I believe, well placed to intensify already self-blaming or scapegoating constructs held by family members and, if this goes unrecognized, such therapy may have a long-term corrosive impact. I suspect, though, that a more common problem with theory is that it may lead to an unbreakable impasse of unacknowledged misunderstanding between family members and therapist in which the theoretically dominated construct in the therapist’s mind deadens curiosity and the creative exploration of différence. I view theories as sometimes-useful maps or stories to stimulate thinking in the therapist – not as moulds for reshaping the family. Theory, I think, is important but it needs to be light, to be held consciously and with a loose grip. I suggest that we cannot not have theory – and by theory I mean any presupposition we may use to select information from the swirling mass of complexity that confronts us when we sit with a family in therapy. In this definition, the thought ‘he reminds me of my neighbour’ or ‘this reminds me of when I . . .’ needs to be managed in the same way as ‘problem saturation’ or ‘cross-generational coalition’ or ‘ADHD’. The term ‘theory’ is thus being used here in formal, vernacular and personal meanings. Theory determines what we bring forth and what we defer. The difficulty with theory is its tendency to both rigidify and slip from conscious awareness in the mind of the therapist with a corresponding loss of reflexivity; a self-conscious awareness that what we see is determined by our choice of theory as lens. Theories are viewed as neither inherently first- nor second-order – instead, these terms refer respectively  1997 The Association for Family Therapy and Systemic Practice


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to the non-reflexive or reflexive use of any theory (Pocock, 1996). A non-reflexive use of theory is likely to lead to misunderstandings – the therapist can only see what the theory allows. Some theories get heavy with unnecessary associations and it then becomes hard to put them aside when they are not working. Theories may need to be degurufied – stripped of their associations with personal heroes.6 If the ideas don’t work on their own they are not worth holding on to. Here, one risks the loss of the image of a guiding parental figure. It may be difficult to think of, say, ‘enmeshment’ without seeing Minuchin changing the seating arrangements or ‘premise’ without the image of circular questioning; but the technique does not automatically belong to the theory. One is in the domain of thinking, the other in the separate domain of doing. By separating these domains, theory is deinstitutionalized. Here, one has to face a fear of not belonging to any institutional practice. A light theory may be held on to less tightly and with greater reflexivity. But lightness can also allow multiplicity. I think one challenge for family therapists is to risk the insecurity and disloyalty of de-identifying from any major theoretical approach, and instead to see them all as possible perspectives from which to look at and think about any therapy situation. Each perspective, in turn, simultaneously reveals and conceals something of the complexity allowing, over time, deeper and richer ways of thinking in the presence of the family. I agree with Hart (1995) that the use of multiple lenses is the logical consequence of postmodernism,7 and with Larner (1995) who attempts, as a paramodern therapist, to ‘remain open to and interested in all metaphors for change, while cognisant of their limitations, excesses and risks’. For example, in a one-parent family in which there are powerful feelings of hate and blame by a mother towards a child who ‘is always naughty’, one may look through the lenses of scapegoating, disengagement and avoidant attachment. Projective identification 6 For example, in the UK, the work of Melanie Klein seems often to be associated with unnecessary gravitas. To counter this I like to think of her down the pub with her mates: ‘that’s two more pints Mel and don’t forget the cheese and onion crisps.’ 7 Therapy trainings, books, journal papers, conferences, workshops all tend to create a discourse of model and theory separation which obscures theoretical pluralism and technical eclecticism, both of which seem to be common aspects of the thoughts and practices of experienced therapists.


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may suggest the idea that what is seen in this child is something disowned by the parent. Countertransference feelings may suggest that the mother assumes that I plan to criticize her. One may then wonder who has recruited this mother into a story of herself as failing and bad – what might her relationship be with teachers, relatives and friends or ex-partner? Is she surrounded by a community of criticism which is legitimized by scapegoating of lone mothers in current societal discourse? And/or has she internalized a critical distant parent and is now caught up in a replicative script? One may build a light structure of such ideas, part or all of which may be rapidly collapsed when it is no longer helping in the work/play of understanding. In one such case, this process of light construction, collapse and reconstruction allowed a thought and then a question to the mother: ‘Who is looking after you?’ Her tears signalled that something of her experience might, after all, be understood. Privileging the subjective experience We may think, in broad terms, of families sharing particular kinds of stories in order to live together (Pocock, 1995a), but feeling understood is the subjective layer of this experience. Only individuals can feel understood – although family members may perhaps come to understand each other better. Each family member needs to hear due attention and consideration paid to his or her voice and position (Boszormenyi-Nagy and Krasner, 1986). The light, fluid and evolving structure of thoughts in the therapist’s mind needs to be oriented to consider each person’s perspective. For example, a girl who was deeply troubled at the experience of moving backwards and forwards between two bitterly warring parents was considered from a structural perspective to be part of a triangulated system. However, this thought could only be translated into something that might be helpful for her and her parents by considering the possible experience of this from each person’s perspective. One of the current tensions in family therapy discourse is whether each family is to be considered entirely unique or whether general principles can be discovered (from observation, theorybuilding and research) in which some or all families are seen as having something in common. Social constructionists favour the unique pole of this debate, although as Fraenkel (1995) points out, this makes it difficult to conceptualize collective issues such as  1997 The Association for Family Therapy and Systemic Practice


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gender, sexuality, class, race and culture. As Fraenkel further suggests, one may simply refuse this debate by choosing neither pole. All families and individuals seem in some ways to be, first, unique, second, like some others, and third, like all others. One can never be sure of the relative size of the proportions. The first allows us to be curious about and appreciative of the unexpected, the second allows us to let people know they are not alone and that others have struggled successfully with similar issues, and the third allows us to experience the other in ourself. Feeling understood may partly depend on the therapist finding some analogue inside him or herself which gives a deeper appreciation of the struggles of each family member. An authentic resonance inside the therapist creates the analogic communication that the family member has indeed been heard. In the case above, I recall two analogues that were available to consider the position of the girl. The first was an experience of liking and respecting two people who quietly loathed each other. I couldn’t bear for either to speak about the other in my presence. The second was a newspaper article I had recently read on the psychological strain of being a double agent. This attempt to appreciate something of the agony of the girl’s position could then be shared with her and other family members for their consideration and feedback. Until recently, empathy was barely discussed in family therapy, but probably much practised (Speed, 1996). (Wilkinson (1992), Perry (1993), and an excellent chapter in Nichols (1987) are notable exceptions.) Empathy is not just a concern for family members but a sustained method of enquiry (Kohut, 1985) into what it feels like to be each person. This is much more difficult when we find little natural resonance. The task of remaining open and receptive to that which is unfamiliar or even alien in others can be onerous – especially when working alone. The capacity to de-centre or move imaginatively into the shoes of others is particularly valuable when sharing ideas with the family or deciding what to explore. One of the skills in a reflecting team, for example, seems to be this kind of empathic monitoring by each team member of the likely effect that earlier comments in the reflection may have had on particular individuals in the family. Team members’ contributions to the reflection then appear to be subtly adjusted by this de-centring process. This, I think, gives reflections their extraordinary potential for holding family members while at the same time introducing fresh ideas.  1997 The Association for Family Therapy and Systemic Practice

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Perhaps the most important condition for understanding is the possibility of family members being able to safely report their feelings of being misunderstood. (Consider, for example, the dilemma of a misunderstood child faced with a team of professionals.) Most obviously, we may create space for misunderstanding by looking out for and inviting feedback. We may notice puzzlement at something we have said and enquire about this, or we may declare our own anxiety about the possibility of being misheard. More subtly, we may need to rely on a commitment to uncertainty – to the notion that there is always something left unsaid and deferred – never a final word. Understanding seems to take time. Constructivism and the pragmatist position of William James (Orange, 1995; Amundson, 1996) may help to moderate our contribution to this continual work/play of understanding. The former accepts that our ideas cannot predetermine the response of family members – but they may fit. The latter suggests that our ideas are without absolute value – but they may be transformed into something of value by family members in negotiating their world. Here, the ultimate test of good-enough understanding is neither correspondence nor coherence (Hamilton, 1993), but use. But feeling understood is more than just useful knowledge; more too than a better story. It is an experience of being more known to and appreciated by others and, through them, to a greater appreciation of oneself. It is a celebration of both our common humanity and of our differences. Summary • ‘According to Howe, families had a great need to understand two things – their problem and their experience of being in family therapy. The stance of the therapists was to focus on behaviour rather than to develop an understanding. They believed that they should concentrate on changing the family behaviour and not worry about whether family members understood how the changes took place. So the situation was non-reflexive – the family was treated as the object not the subject of therapy.’ (Reimers and Treacher (1995), reviewing Howe’s (1989) consumer study of family therapy from the none too distant past.) • ‘No one really understood what we lived through. They never did really understand the situation. How badly it was upsetting us all. It was all too simple for our case. Just lots of questions. You answered one and boom! onto the next one. They never got to the bottom of anything. There was so  1997 The Association for Family Therapy and Systemic Practice


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much I wanted to say but I couldn’t say it their way.’ (‘Luke’s mother’ – one of the majority in Howe (1989) who did not feel understood.) • ‘Postmodernism believes in a reality beyond words, it just believes that the world beyond words is understood differently depending on how we agree to describe it.’ (Shawver, 1996.) • ‘It is in the gaps and breakdowns of language that reality inheres; in this sense, postmodernism points to the insufficiency of language as a means of embracing experience.’ (Frosh, 1995.) • ‘My own view of psychoanalytic understanding must remain provisional and open to surprise. Only then can I join the other in a healing process of making sense together.’ (Orange, 1995.) • ‘If one cares to inspect the road between Gretna, Carter Bar or Berwick, the black line remains elusive. The border is “there” only because enough of us are prepared to live with that fiction.’ (Birch, 1996, on the English/Scottish border.) • ‘It seems the case that effective therapy is less contingent upon a truth associated with a particular theory or practice than the application of that truth in the ever pragmatic crucible of the therapeutic moment.’ (Amundson, 1996.) • ‘I felt that they got down to the nitty-gritty of what was wrong. They knew, like, what was going on so that . . . er . . . the way they put it, you knew you were coming across to them and they like, in their way was coming across to us.’ (‘Mr Vassal’, in Howe, 1989.) Acknowledgements My thanks to Carmel Flaskas, Lois Shawver and Maggie Usher for their helpful comments on earlier drafts of this paper. References Amundson, J. (1996) Why pragmatics is probably enough for now. Family Process, 35: 473–486. Andersen, T. (1987) The reflecting team: dialogue and meta-dialogue in clinical work. Family Process, 26: 415–428. Anderson, H. and Goolishian, H. A. (1988) Human systems as linguistic systems: preliminary and evolving ideas about the implications for clinical theory. Family Process, 27: 371–391. Anderson, H. and Goolishian, H. A. (1992) The client is the expert: a not-knowing approach to therapy. In: S. McNamee and K. Gergen (eds) Therapy as Social Construction. London: Sage. Bateson, G. (1972) Steps to an Ecology of Mind. New York: E. P. Dutton.  1997 The Association for Family Therapy and Systemic Practice

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Bentovim, A. and Kinston, W. (1991) Focal family therapy: linking systems theory with psychodynamic understanding. In: A. Gurman and D. Kniskern (eds) The Handbook of Family Therapy, Volume II. New York: Brunner/Mazel. Bion, W. (1974) Brazilian Lectures 1. Rio de Janeiro: Imago Editora. Birch, J. (1996) Comment: Borderlines. Journal of Family Therapy, 18: 285–288. Boszormenyi-Nagy, I. and Krasner, B. R. (1986) Between Give and Take: A Clinical Guide to Contextual Therapy. New York: Brunner/Mazel. Box, S., Copley, B., Magagna, J. and Moustaki, E. (eds) (1994) Crises at Adolescence: Object Relations Therapy with the Family. New York: Aronson. Breunlin, D., Schwartz, R. and Karrer, B. (1992) Metaframeworks: Transcending the Models of Family Therapy. San Francisco: Jossey Bass. Byng-Hall, J. (1995) Rewriting Family Scripts: Improvisation and Systems Change. London: Guilford. Casement, P. (1985) On Learning From the Patient. London: Tavistock. Dare, C. (1989) Symptoms and systems: an exploration with anorexia nervosa. Journal of Family Therapy, 11: 21–34. de Shazer, S. (1991) Putting Difference to Work. New York: Norton. Dell, P. (1982) Beyond homeostasis: toward a concept of coherence. Family Process, 21: 21–41. Derrida, J. (1972) Limited, Inc. Evanston, IL: Northwestern University Press. Efran, J. and Clarfield, L. (1992) Constructionist therapy: sense and nonsense. In: S. McNamee and K. Gergen (eds) Therapy as Social Construction. London: Sage. Epston, D. and White, M. (1992) Experience, Contradiction, Narrative and Imagination: Selected Papers of David Epston and Michael White 1989–1991. Adelaide: Dulwich Centre Publications. Flaskas, C. (1993) On the project of using psychoanalytic ideas in systemic therapy: a discussion paper. Australian and New Zealand Journal of Family Therapy, 14: 9–15. Flaskas, C. (1994) Postmodernism, constructionism and the idea of reality: a contribution to the ‘ism’ discussions. Australian and New Zealand Journal of Family Therapy, 16: 143–146. Flaskas, C. (1996) Understanding the therapeutic relationship: using psychoanalytic ideas in the systemic context. In: C. Flaskas and A. Perlesz (eds) The Therapeutic Relationship in Systemic Therapy. London: Karnac. Flaskas, C. (1997) Reclaiming the idea of truth: some thoughts on theory in response to practice. Journal of Family Therapy, 19: 1–20. Fish, V. (1993) Poststructuralism in family therapy: interrogating the narrative/conversational mode. Journal of Marital and Family Therapy, 19: 221–232. Fraenkel, P. (1995) The nomothetic-ideographic debate in family therapy. Family Process, 34: 113–122. Frosh, S. (1991) The semantics of therapeutic change. Journal of Family Therapy, 13: 171–186. Frosh, S. (1995) Postmodernism versus psychotherapy. Journal of Family Therapy, 17: 175–190. Gergen, K. and Kaye, J. (1992) Beyond narrative in the negotiation of therapeutic meaning. In: S. McNamee and K. Gergen (eds) Therapy as Social Construction. London: Sage. Goldner, V., Penn, P., Sheinberg, M. and Walker, G. (1990) Love and violence: gender paradoxes in volatile attachments. Family Process, 29: 343–364.  1997 The Association for Family Therapy and Systemic Practice


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Hamilton, V. (1993) Truth and reality in psychoanalytic discourse. International Journal of Psycho-Analysis, 74: 63–79. Hart, B. (1995) Re-authoring the stories we work by: situating the narrative approach in the presence of the family of therapists. Australian and New Zealand Journal of Family Therapy, 16: 181–189. Hart, B. (1996) The construction of the gendered self. Journal of Family Therapy, 18: 43–60. Hoffman, L. (1993) Exchanging Voices: A Collaborative Approach to Family Therapy. London: Karnac. Holmes, J. (1996) Psychoanalysis – an endangered species? Psychiatric Bulletin, 20: 321–322. Holmes, J. and Lindley, R. (1991) The Values of Psychotherapy. Oxford: Oxford University Press. Howe, D. (1989) The Consumers’ View of Family Therapy. London: Gower. Knight, L. (1986) Talking to a Stranger: A Guide to Psychotherapy. London: Hodder & Stoughton. Kohut, H. (1985) Self Psychology and the Humanities: Reflections on a New Psychoanalytic Approach. New York: Norton. Kraemer, S. (1994) The promise of family therapy. British Journal of Psychotherapy, 11: 32–44. Larner, G. (1995) The real as illusion: deconstructing power in family therapy. Journal of Family Therapy, 17: 191–217. Launer, J. (1996) ‘You’re the doctor, Doctor!’ is social constructionism a helpful stance in general practice consultations? Journal of Family Therapy, 18: 255–268. Lieberman, S. (1979) Transgenerational Family Therapy. London: Croom-Helm. McCluskey, U. and Bingley Miller, L. (1995) Theme focussed family therapy. Journal of Family Therapy, 17: 411–434. McNamee, S. and Gergen, K. (eds) (1992) Therapy as Social Construction. London: Sage. Miller, S., Hubble, M. and Duncan, B. (1995) No more bells and whistles. Networker, March/April. Morrison Dore, M. (1996) Preserving families at risk of child abuse and neglect: the role of the helping alliance. Child Abuse and Neglect, 20: 349–361. Nichols, M. P. (1987) The Self in the System: Expanding the Limits of Family Therapy. New York: Brunner/Mazel. Orange, D. (1995) Emotional Understanding: Studies in Psychoanalytic Epistemology. New York: Guilford. Orbach, S. (1994) What’s Really Going on Here? London: Virago. Parry, A. (1991) A universe of stories. Family Process, 30: 37–54. Perry, R. (1993) Empathy – still at the heart of therapy: the interplay of context and empathy. Australian and New Zealand Journal of Family Therapy, 14: 63–74. Pinsof, W. M. (1994) An overview of integrative problem centred therapy: a synthesis of family and individual psychotherapies. Journal of Family Therapy, 16: 103–120. Pocock, D. (1995a) Searching for a better story: harnessing modern and postmodern positions in family therapy. Journal of Family Therapy, 17: 149–173. Pocock, D. (1995b) Postmodern chic: postmodern critique. Context, 24: 46–48. Pocock, D. (1996) Comment: reconciling the given and the made. Journal of Family Therapy, 18: 249–254.  1997 The Association for Family Therapy and Systemic Practice

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Reimers, S. and Treacher, A. (1995) Introducing User Friendly Family Therapy. London: Routledge. Scharff, D. and Savege Scharff, J. (1987) Object Relations Family Therapy. Northvale, NJ: Aronson. Seligman, M. E. P. (1995) The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50: 965–974. Shawver, L. (1996) What postmodernism can do for psychoanalysis: a guide to the postmodern vision. The American Journal of Psychoanalysis, 56: 371–394. Skynner, R. (1987) Exploration with Families: Group Analysis and Family Therapy. London: Tavistock/Routledge. Speed, B. (1984) How really real is real? Family Process, 23: 511–520. Speed, B. (1991) Reality exists O.K.? An argument against constructivism and social constructionism. Journal of Family Therapy, 13: 395–409. Speed, B. (1996) You cannot not relate. In: C. Flaskas and A. Perlesz (eds) The Therapeutic Relationship in Systemic Therapy. London: Karnac. Stolorow, R., Atwood, G. and Brandchaft, B. (1994) The Intersubjective Perspective. Northvale, NJ: Aronson. Wilkinson, M. (1992) How do we understand empathy systemically? Journal of Family Therapy, 14: 193–206.
