Magazine article Family Therapy Networker

Book Review: Prisoners of Our Metaphors

Magazine article Family Therapy Networker

Book Review: Prisoners of Our Metaphors

Article excerpt

Do dialogic therapies make other methods obsolete?

THERAPEUTIC CONVERSATIONS EDITED BY STEPHEN GILLIGANAND REESE PRICENew York: W.W. Norton 362pages, $34.95

THE NEW LANGUAGE OF CHANGE EDITED BY STEVE FRIEDMANNew York: Guilford Press 464 pages, $36.95

METAPHORS OF FAMILY SYSTEMS THEORY BY PAUL C. ROSENBLATTNew York: Guilford Press 239 pages, $26.95

WHEN SOMEONE HAS A PROBLEM, THERE are two basic questions he or she can ask: How did I get into this mess? and How do I get out of it? One hundred years ago, Freud decided the former question was the more important one, and much of the history of psychotherapy has been about finding myriad ways to answer it. In the last 10 years, however, the other question has become increasingly popular among psychotherapists. A new form of psychotherapy has emerged based on discovering and amplifying ways of moving away from the problem looking less at what is wrong with the client and more at the ways in which he or she might deal more effectively with life's difficulties or has already done so in the past.

Grand claims have been made for this shift, yet it is still a movement in search of a good name and is apt to be known by particular methods that exemplify its principles, such as solution-focused or narrative therapy, even though the movement is larger, more complex and more important than any single approach. For want of a better term, I have settled on "dialogic therapies" as a more inclusive label because the spirit of collaborative and nonconfrontational conversation is so central to this philosophy of treatment.

The basic tenets of the dialogic therapies are:

A deemphasis on the analytical expert role of the therapist and emphasis instead on a mutual process of "unraveling mysteries";

Close attention to what clients say, how they say it, and (most important) what that implies about their worldviews and belief systems;

The belief that changing how people talk about problems and solutions can completely alter their relationship to those problems and solutions "how we talk is who we are," so to speak. In this view, the statement, "I'm very insecure" is less a self-description than a map for one's future, directing one's attention only to what supports that belief, and away from anything that might revise it;

A thorough skepticism about (and often outright dismissal of) "deeper structures" such as three-generational patterns, unconscious motivation, family rules systems and the role of the past, which are the heart of other methods. According to dialogic thinking, the belief in such deeper structures "I'm this way because of my childhood" is the real problem as it mires people in a sense of immutability; A far greater interest in the future than the past, and in how people have solved or will solve problems than in how they came to have them. Accordingly, dialogic therapists are less apt to ask "Why do you think you do this?" than "When do you succeed in not doing it?" or "What do you think will help you to do it less or not at all?";

Finally, and perhaps most important, an intense commitment to seeing problems as separate from the people experiencing them. "He steals things" is a very different understanding of the problem than "He is a thief." "He is a thief emphasizes that his stealing represents a deeper, intrinsic part of him and requires personality change. "He steals things" suggests that the problem would be solved if he stopped stealing things a much more achievable outcome.

In the dialogic therapies, constructivism has finally found concrete clinical application. The premise of all the dialogic approaches is that it is not the historical past that creates problems, but the stories we attach to the past, the meaning and labels we ascribe to them. The dialogic therapies move away from a notion of the past as having a pattern and a meaning, toward the notion that any past has multiple meanings, multiple ways of being understood, and many, many different representations at different times. …

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