I have been clinical director of the marital and family therapy program at Michigan State University for about 10 years. Prior to that I was in clinical practice for 25 years. The settings in which 1 was professionally educated and trained will tell you a lot about my current family therapy orientation. Formal family therapy programs did not exist when I started out. If they had, I probably would not have noticed them. My master's degree and doctorate were in experimental social psychology and I was deeply impressed by Kurt Lewin's field theory, general systems theory, and Piaget's notion of assimilation and accommodation. Each described individuals transacting with their immediate environments and both being changed in the process.
I then entered a postdoctoral clinical internship in marital and family counseling where I tried to make sense out of what I was seeing: children in treatment but their behavior apparently a product of what their parents were doing; and families quitting treatment just when I thought progress was being made. Following that experience, I went to work in a large general medical and surgical hospital where I specialized in those conditions antecedent to, attendant upon, parading as, or subsequent to physical illness. I was intrigued by the "why now?" question. Why did people get sick when they did? Why did they seek treatment when they did? Why were many individuals noncompliant with their treatment regimens? Why did many not want to leave the hospital? And so on.
I had found psychodynamic theory only moderately useful in the counseling internship and less so in the medical hospital. I fell back on the theorists who had impressed me in graduate school. I quickly discovered that the answers to my questions in both settings involved appreciating the social contexts in which indi-