Academic journal article Journal of Marital and Family Therapy

A Personal Retrospective of the Family Therapy Field: Then and Now

Academic journal article Journal of Marital and Family Therapy

A Personal Retrospective of the Family Therapy Field: Then and Now

Article excerpt

A few years ago, I was taken aback to read an article characterizing the work of Nathan Ackerman, Murray Bowen, Ivan Boszormenyi-Nagy, and myself as "faintly Victorian." So when I started formulating ideas for this speech, I wondered what I could tell this audience in this so-called postmodern family therapy era of political awareness; gender, race, and class sensitivity; ethnic diversity; constructivism; and co-created stories. What could I say that would not seem irrelevant in this political climate? Are the founders of the field viewed as having gone the way of the horse-drawn carriage?

Those of you familiar with my work know that I believe in the healing and power of the past and that knowledge of history helps make sense of the present. So I invite you to accompany me on this journey through the years of the family movement, from the 1950s to the 21 st century. As one who was there at the beginning, I offer a perspective that may provide a context for seeing how we came to be where we are now and where we might want to go. There may be value in knowing how a small group of mavericks from the traditional mental health professions, working in different parts of the United States, independently came to develop a revolutionary paradigm about intimate relationships, emotional disorders, and treatment. I want to say at the outset that I do believe that family system theory and therapy is an exciting, creative approach that has made and will continue to make a profound contribution to assessing and ameliorating many varieties of human distress. I truly believe in it. I also want to state for the record that family therapy is not a technique nor a subdivision of psychiatry, psychology, or social work but a separate profession with its own conceptual model, rationale of treatment, methods of training and research. But I need to remind you of this caveat: the traditional way of diagnosing and treating emotional problems is still the dominant power in the mental health field, reinforced by descriptive psychiatry (the DSMs), clinical psychology, biological psychiatry, the insurance companies, and the laws governing mental disorders.

The formidability of these forces, based on old traditions and political and economic considerations, is exercised, for example, through their administrative control in institutions and agencies-determining such things as salaries, titles, clinical practice, methods of training, and research. A recent, thoughtful, and important paper (Shields, Wynne, McDaniel, & Gawinski, 1994) suggests that by becoming an independent profession, family therapy is likely to become marginalized and isolated from the rest of the mental health professions. The article proposed that family therapists get in line with other mental health professionals who assess disturbed behaviors as mental disorders. Such a stance obviates why family systems theory and therapy came into being in the first place. The unique contribution of family systems theory was that individuals do not exist in a vacuum and that "mental disorders" are usually by-products of the reciprocal influences of intimate emotional systems. To go back to acontextual diagnostic category thinking would be a regressive step in my judgment. It has never occurred to me that family therapy would exist outside the mental health professions. I have spent my entire professional life (in various settings: mental hospitals, medical schools, psychology departments, giving workshops) trying to influence the traditional mental health professions. Since family systems concepts made sense, these traditional professionals were frequently moved to reexamine clinical situations. Rather than waning, as the Shields et al. article states, the influence of family therapy seems to be growing; there is considerable evidence that its conceptualizations and practices have had increasing impact over the years. For example, psychiatrists, psychoanalysts, and clinical psychologists now often treat marital relationship problems by seeing partners conjointly, even when the individual partners have no diagnosable psychiatric disorder. …

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