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Introduction

This book consists of 12 descriptions by senior family therapists of trajectories from their origins in the field to their current originality , for each of whom to a greater or lesser extent, EFTA may have provided a secure base that allowed their creativity to flourish. Carefully reading the chapters generated for us a sense of how such trajectories could provoke many ideas about how systemic couples and family therapy (SCFT) could develop. We hope that bringing together and into conjunction, examples of material from all of the chapters will create a sense of the ways our field has progressed from its origins to its current originality. We have also been inspired by the emerging patterns to suggest some other potential developments that may launch us beyond the chapter content into further possibilities.

Every systemic family therapist continually encounters demands on them for creative originality . We need all our ingenuity as our clients bring ever new challenges; but also to make use of the political and financial contexts of our work; and the need to enthuse and challenge each new generation of trainees. Our field is having to recognise that achieving a sound level of habitual practice is no longer enough. As Ericsson (2006) says, after training and years of experience, practitioners “… are able to work as independent professionals. At that time most professionals reach a stable, average level of performance, and then they maintain this pedestrian level for the rest of their careers. In contrast, some continue to improve and eventually reach the highest levels of professional mastery.” (p. 685).

This volume is a set of examples of how our founders and presidents have developed from their origins to be able to offer richly varied examples of originality . Our hope is that our readers will take this demonstration of many different ways “to achieve a step change from acceptable competence to a higher level of mastery” (Stratton and Hanks 2016, p. 8) as inspiration and encouragement to seek out their own forms of applicable originality. And that this continuing enhancement of our field will also find a home in EFTA in future years.

The Political Context of Our Work

Both the needs and the contributions of families are consistently undervalued by our governments and health, especially mental health, services. Despite rhetoric about the importance of families, wellbeing and stable relationships, work-life balance, importance of early years, etc., the actions of governments most often either ignore or undermine families while the provision of family therapy and other forms of family support is continually under attack. From within the mental health professions we face the increasing pressure to only treat, and obtain data about, people with a clear diagnosis which in terms of DSM increasingly requires a biological basis. With the financial resources for lobbying being held by the drug companies we see an increasing move back to having psychological distress treated with drugs or at best, by cognitive and behavioural treatments that can be packaged and researched in parallel ways.

As Juan Luis Linares says, “there is a place here for the diagnosis of psychopathology , not, however, as a way of labelling deviant behaviour, but rather as a system of guiding metaphors that facilitate our understanding of complex and dysfunctional relational phenomena.” The most effective way of deconstructing conventional psychopathology is to achieve a deeper understanding of its relational bases.

Arlene Vetere adds that the task of explanation becomes one of integration, formulation and critical reflection and it needs to be useful. A plea that progress demands a more theoretically integrated approach, across all social and health care disciplines. We might add that it also requires a close engagement with our research base so that we are able to capitalise on it to demonstrate at every opportunity the unique and powerful contribution that SCFT can make to addressing mental health issues, to the welfare of families, and to progress towards well-functioning societies.

The reports in several chapters from the exciting early days of EFTA draw our attention to current needs for political involvement to support our field. EFTA has in many contexts led the way, especially Mony Elkaïm, Jacques Pluymaekers, and our successive presidents. See especially Jacques Pluymaekers’ descriptions of the early days of radical SFT in Europe and Quebec, and Mony Elkaïm’s account of the early movements to replace psychiatry, and the application of systemic approaches to societal and international conflicts. The need for such systemic radicalism has not diminished but reading about the heady early days does raise the thought that maybe as our profession has become established we newer generations might have lost some of the fire and courage of the originators. But the content of this book suggests that it might just be that we are agitating on many more different fronts so that there is less sense of a focussed campaign.

A major area of current concern is explored by Maria Borcsa and Julia Hille as they consider the changes brought about by the twin forces of increased migration and developing information and communication technologies (ICTs). Each of these has significance for altering family structures and while geographical changes may most often result in dispersion and reduced communication of families, the technological changes are often a means of ameliorating such effects. They also have consequences such as “deterritorialised identities ” that will come to have political impact.

While EFTA members are politically active in many ways in different European countries we see in our first EFTA volume great diversity in the work with a variety of clienteles, contexts etc. and the achievements of this kind of wider application provide a base for the political action that is increasingly needed. We hope this book will provide authoritative material that readers can use to support the argument that family therapy and wider forms of systemic practice have a much greater potential contribution than is currently recognised.

A newer impetus that is less direct than the examples of political involvement of our founders and presidents , could come from elsewhere in the fields of systemics. Some opportunities for political involvement are suggested in the later section “Developments Within Systemic Theory and Practice ”.

Developments in Family Therapy Theories

A case can be made that the early forms of systemic family therapy were strongly influenced by a wish to differentiate from the dominant psychoanalytic models of the time. And that we have continued to promote each new advance by claiming it supersedes, and renders irrelevant, previous achievements. It does not take a very sophisticated use of systemics to recognise that the attempt to define yourself by your difference from a previous model inevitably leads to giving the previous structures a powerful influence in shaping your innovation. The pattern has applied more recently in attempts to create forms of family therapy that are claimed to reject the systemic model. One of the most obvious ways this has worked has been the ways that recent innovations such as narrative therapy and brief solution focussed therapy have often had more to say about treatments of individuals than of families. At the same time while practice involving individuals has less to say about working with wider systems, others are operating as if the best intervention for a family is to focus all efforts on changing the wider systems within which it operates.

A clear analysis of some of the unproductive moves of the last 25 years is presented by Juan Luis Linares’ development of an ultramodern position to overcome the limitations he describes that have resulted from inappropriate importations of other theoretical positions see his critique of social constructionism and post-modernism, the rise of improvisation and a neo-Marxist tendency and his recommendation of returning the focus from just the individual or just society, to the family as intermediary between those two. His analysis leads to a proposal to ensure we recognise the privileged position held by the family system as an essential intermediary between the individual and society. As he says “we should put an end to postmodern dogmatism and throw open the windows of the systemic world to fresh and demythifying air that brings with it all that is good in the psychotherapeutic tradition”.

Others among our authors offer significant developments in aspects of their theories without the need to reject our systemic origins or claim they are superseding all the wisdom we have painfully acquired. For Luigi Onnis the operation of time means that changes are irreversible: once a system is changed it cannot return to the previous system. Time is taken up in a very sophisticated analysis by Hugh Jenkins reviewing concepts of time both in different forms of therapy and other traditions of thought from the ancient Greeks through early Christians to a variety of more recent European perspectives. Leading to the concept of therapy as a “liminal ” space, inhabited by patient and therapist, located at the margins.

For Juan Luis Linares the liberation from the reductionist cause–effect thinking eliminates the resulting paralysing issues of guilt and blame . From a systems point of view, nobody is to blame, but everybody is responsible for the necessary change in the pattern of interactions. In this way we can accept that the way in which some parents treat their children psychologically must cease to be a taboo for family therapy.

Theo Compernolle also argues in some detail that we should not expect to see linear cause–effect sequences but unique stochastic processes (transactions) so we must always look at wider (higher) systemic levels. We return to this theme later in this chapter.

Mony Elkaïm describes the influences and contexts of his moving on from early rather mechanical systems and cybernetics with the application to family systems of I. Prigogine’s theory on systems far from equilibrium (Prigogine and Nicolis 1977). For Mony Elkaïm this led to the introduction of a new model for couple therapy as well as the development of his influential concepts of “resonances ” and “assemblages”. A similar progression is described by Luigi Onnis as a move from homeostatic to evolutionary models.

Juan Luis Linares takes the development to an even more advanced level with his account of an ultramodern position. He claims that this systems point of view “jettisons most turf fights and power struggles between professionals from different schools and disciplines and improves collaboration. Ideas about why people and families behave as they do, are resolved when these ideas are no longer formulated as truths, but as simplified representations of a part of reality at a particular systems-level and as hypotheses to be tested all the time in the therapeutic process. This does not mean that all methods and techniques are of equal value. We need research to find out how efficient and reliable they are.”

Mony Elkaïm progresses to thinking less in terms of systems composed of individuals in interaction and more in terms of interrelationships of “assemblages”, which supports his creation of the reciprocal double-bind concept (love me, don’t love me) to his powerful analysis of resonance. Human systems can be analysed as relations between world view systems rather than between individuals. The use of resonance analysis thus becomes a crucial tool.

For Arlene Vetere, systemics provides us with a reflexive framework to map pattern and process and communication and meaning-making in our relationships, but not a theory of content. The integration of large and well-researched systems of thought—attachment theory , narrative theory , trauma theory—with systemic theory and practice provides a powerful explanatory model. She proposes the implications of attachment theory research to be:

  1. (a)

    naming and regulating emotions,

  2. (b)

    standing in the emotional shoes of the other,

  3. (c)

    comforting and self-soothing,

  4. (d)

    information processing,

  5. (e)

    transformations in representational systems .

Attending to content and systemic context Kyriaki Polychroni describes concepts of “multi-level, multi-focal models of intervention”, “subjective culture ” and “cultural chronos and the multiplicity of inner voices “developed during the history of the Athenian Institute of Anthropos (AIA). Meanwhile Theo Compernolle suggests an eco-psycho-somatic approach to therapy to better integrate relevant knowledge from different scientific domains and to pay special attention to what goes on at the interface between them.

Novel Practices in Therapy and Training

As is to be expected from a book by highly experienced practitioners, we are offered many practical ideas about therapy and training that could be exported to our own contexts. Many are very relevant to our earlier suggestion of the centrality of creative originality in therapy and training.

Jorma Piha and Florence Schmitt give us an intriguing account of sculpting while verbal explanations are excluded so that the participants do not even know which family member they represent. While some readers may well be tempted to take up this technique, it raises a more general consideration which could be extended to other ways of preventing use of the dominant communication channel, e.g. planning therapy with a deaf or blind client. This deliberate removal of the sometimes over-dominant channel of verbal communication has a counterpart in Edith Goldbeter’s process of turning an apparent obstruction, the unavailable but highly significant missing person, into a major resource for the therapy. These are two examples of how, through overcoming a clear limitation, we can transcend the limits of habitual practice. As Jorma Piha and Florence Schmitt say: “He/she has to combine rigour with creativity , meticulousness with flexibility and seriousness with imagination”.

A model of these virtues comes from Jacques Pluymaekers’ account of creating practice for under-resourced neighbourhoods in la Gerbe clinic. In Mony Elkaïm’s chapter we also find the creativity that we see in his live presentations, conveyed by his description of moving from origins in network practices, through to his example of pictorial resonances . The goal of the supervision is not just to “understand” but to “feel differently” about the rapport with the patients: to change the affect.

In further suggestions of resources for therapists in action Hugh Jenkins describes ritual as a way of creating change, and of therapy as a rite of passage. Juan Luis Linares proposes that the ultramodern therapist is happy to submit his or her expertise to the family’s judgment. The kind of intelligent therapeutic intervention that is sought by ultramodern systemic therapists incorporates collaborative conversation but does so in conjunction with scripts or road maps that give some direction when conversing. Family members are aware that the therapist “knows”, and also that he or she will not use this knowledge to tyrannise them or impose upon them realities that they are not ready to accept. Mony Elkaïm provides an extension of this way of thinking in that through resonance the therapist’s experience is amplified by the human system in which he/she is participating to reinforce the world views of the other members of the system.

In a chapter of very practical suggestions Edith Goldbeter explicates her concept of a “nodal” third —the missing person. How the absence of a person can lead to disorganisation which the therapy must help to be recognised and if necessary, mourned. As this is achieved we can start talking of “light thirds ” instead of nodal thirds . As a practical technique she describes the use of the missing person’s chair as a metaphor . As Maurizio Andolfi says, constructing metaphors is one of the best ways to strengthen a therapeutic alliance with the family.

For Luigi Onnis, practice involves a shift from an epistemology of description to an epistemology of construction, from an epistemology of observed systems to an epistemology of self-observant systems, which provides at least two important results: The first relates to the cognitive sphere: once the myth of neutrality and separation has been abandoned … the therapist withdraws the pretence of an objective knowledge of the therapeutic reality interpreted as an “absolute truth”; The second consequence relates more directly to the therapeutic process: the therapist losing their distant and “external” position, must also give up the claim to control the therapeutic process and predict outcomes.

Jorma Piha and Florence Schmitt’s non-verbal sculpting which is used in the training of family therapists to increase their self-awareness of their family of origin issues, can additionally be used as a means of clinical supervision when trainees work with families. In this way the meaning and importance of non-verbal interaction within the family therapeutic system is highlighted. But they point out that monitoring the family sculpting process is demanding. The monitor has to be sensitive and mature as a person as well as professionally.

A different approach is how Maurizio Andolfi builds a solid therapeutic alliance with the family through the active collaboration of the problem child, who is invited to become a sort of co-therapist. In this way children are engaged in therapy as significant relational bridges in the dialogue/clash between generations. He analyses the cognitive and affective qualities required by therapists to enter with passion and empathy into the most difficult and painful issues of the family without a judgmental or culturally stereotyped attitude. For this, playing and playfulness represent the most articulate and personal means of engaging the family and the therapist in the therapeutic encounter. But he points out that it is, nonetheless, still little used by family therapists, who prefer by far an adult and serious model of communication.

Kyriaki Polychroni describes methods of application that include “systemic group therapy ”, and experiential training in family dynamics/therapy is described showing how the integration of other modalities into our family therapy models can optimise our systemic practice. “synallactic collective image technique ” is essentially a cognitive-emotional tool that uses images in activating analogical processes, which facilitate the expression of personal stories. She describes later developments in which the incorporation of attachment and the Emotionally Focussed Therapy (EFT) have also affected the manner in which AIA conduct couple therapy groups . She draws attention to how including specific experiential inner dialogue exercises can help to foster partners’ accessing primary emotions and attachment yearnings and other experiential tasks that guide couples in restructuring their relational patterns.

Maria Borcsa and Julia Hille conceptualise their interview process consisting of four parts, (1) the structural genogram ; (2) uniqueness variables; (3) relational spaces of belonging; and (4) use of information and communication technologies. From this conceptual approach and by a careful consideration of the literature, they construct the “Genogram 4.0”. They provide a table which shows sample items for each of these headings. The interview also builds up to a focus on the impact of ICT has on the life of the therapist; moreover, the authors suggest ways how the interview can be extended during training.

Developments Within Systemic Theory and Practice

Another theme that cuts across the three sections into which we grouped the chapters, is progression, liberation even, from early concepts of systemics. From here we feel it particularly appropriate to start using the insights of our authors as a springboard for more general considerations. Our field has progressed through increasing sophistication in the ways the systemic metaphor has been used as a basis for both theory and practice. As described above, in several chapters an account of such progression is reported by the author and taken together, these give a map of current systemic thinking. As we pull together the strands of innovation from the whole book, we are by now beginning to see areas which could be particularly fruitful in the future. The accounts of changing use of systemics could lead us to recent developments in other areas of systemic sciences which we introduce after reviewing some of the experiences of our authors.

Mony Elkaïm describes becoming liberated from von Bertalanffy and systems theory with its emphasis on homeostasis and keeping families stable, to Prigogine with the therapist’s task becoming an agent of change rather than stability. Petros Polychronis had planned to present at the EFTA-TIC conference in 2015 an account of dissipative systems where being further from equilibrium creates more complexity and less linearity; chaotic dynamics are extremely sensitive to initial conditions where unpredictability allows for the emergence of novelty; downwards causality , etc. Luigi Onnis, also building on Prigogine advocates taking complexity theory as an important newer area of systemics. Though as Melo and Alarcão say “Family therapy has advanced, since its inception, in close connection with systems’ sciences and cybernetics. But it hasn’t kept up with the new developments in complexity sciences” (2015, p. 86).

So we might extend these considerations by opening our field up to current complexity theory. A first thought is that although the families we see are complicated, complexity has a more specific and carefully worked set of meanings. The difference is discussed by Poli (2013) writing on “the difference between complicated and complex social systems”. Complexity science is not a single theory but is attempting to establish the general principles of complex adaptive systems. And it is highly interdisciplinary, seeking the answers to some fundamental questions about living, adaptable, changeable systems. The literature covers many different areas but with rather few references to families as objects of study from this perspective. If we start to engage rather more with other systems sciences we might hope not just to be consumers of their advances, but to recruit them to apply their insights to the systemics of families and their contexts.

For Theo Compernolle, “systemic” must include the system of the individual and the system of professional interventions, not just the family system . He maps out levels of systems saying the crucial task is to choose at which level to intervene. He echoes Juan Luis Linares in his call to consider unique stochastic processes which implies always looking at wider (higher) systemic levels.

Theo Compernolle’s conclusion is that “systems theory , or developing a “systems zoom-lens” will help a therapist or coach to integrate learning from very different disciplines and schools. Medicine, neurology, biology, psychiatry, psychotherapy management, and family therapy for example are not in conflict with each other but they deal with different system-levels. On these levels one can make different observations, different hypotheses leading to different interventions. One can never totally understand what happens on one level only based on knowledge about other levels. One cannot, for example, fully understand what happens at an individual level with only knowledge about the family and vice versa. For the therapist this idea greatly widens her scope of observation and intervention”.

As Luigi Onnis moves from pragmatics to complexity , we might think outside of our selective uses of systems theory to consider areas such as soft systems methodology and anticipatory systems theory (AST) (Stratton 2016). These approaches have already done some of the work that we will need in order to implement the proposals in this book of taking our systemic views further. Maria Borcsa and Julia Hille’s Genogram 4.0 can be viewed as an extension of systemic levels perhaps best seen as an orthogonal dimension. Our old image of concentric circles of systems (individual, family, community, state etc.) is challenged by globalisation, transnational families , and the grafting on of systemic communicative capability through constantly evolving ICT.

The core principle of AST is that an anticipatory system is one that incorporates a model of itself which it can interrogate (Louie 2010). So whereas a basic (cybernetic) system is driven by feedback from the environment (judging the distance from a goal and taking action to move in that direction), an anticipatory system uses feedforward. In fact we routinely make use of this capability by inviting our clients to envisage themselves in a desired future so that we can work back to changes that would be needed now. In therapy AST suggests that instead of considering family interactions in terms of feedback which maintains stability, we become alert to the ways they are continually anticipating the thoughts, feelings and behaviours of themselves and each other. When an anticipatory system uses feedforward, rather than examining the environment it may be primarily examining its model. Of itself and its environment.

But we must leave the wider systemic possibilities here, and move on to other resources.

Wider Resources and Contexts of Application

Several of our authors point to areas beyond the strict boundaries of family therapy and systemic practice. Theo Compernolle suggests an eco-psycho-somatic approach to therapy to better integrate relevant knowledge from different scientific domains and to pay special attention to what goes on at the interface between them thereby integrating widely different approaches and contexts of application. And we have the extraordinary range of scholarship of Hugh Jenkins’s discussion around concepts of time both in different forms of therapy and other traditions of thought. He particularly argues that we should tap resources from anthropology and neuropsychology.

It is not just sources of knowledge that we might access, but contexts of application. Kyriaki Polychroni attends to wider cultural contexts and how the rapid changes can leave families bewildered and unprepared, which suggests that we need to attend to current empirical work within the sociology of the family.

Luigi Onnis points to the existence of an isomorphism between different systems (in forms considered by Bertalanffy) and in another direction by stimulating a fruitful integration between the various fields of scientific knowledge.

There are so many areas of knowledge and research that we could draw on to spark our creativity and ground our practice: psychological development of the child; sociology and anthropology of families; major statistical data bases such as the UK household survey; cognitive psychology; and of course robotics, neurobiology and brain sciences are just a few.

Jorma Piha and Florence Schmitt point out: “At that time, we couldn’t understand how research on infants, early interaction, pre-natal and post-natal communication would totally revolutionize our knowledge of the ontogenesis of narratives . The works by Stern (1985), Siegel (1999), Damasio (1999) and others in the late nineties and at the beginning of the new millennium opened new doors to understand how stories start from bodily movements and sensations.”

Then we have Arlene Vetere’s chapter showing how earlier work on attachment became integrated in her work with a narrative approach within a systemic framework. When describing transformations in representational systems she builds the analysis through psychological research on different forms of memory.

Maria Borcsa and Julia Hille review what is currently known about forms of communication and familial contact using ICTs. But both the hardware (like phones) and the contexts of use (like WhatsApp) are continually changing and we need to be aware of developments, even if not competent in them, if we are to understand their roles in families. We will progressively need to consider how can we use mass social media to give families systemic resources. As we write the Financial Times (2nd April, 2016) reports Satya Nadella, chief executive of Microsoft saying that a new force is sweeping through the computing world: the power of conversation. As an averagely insecure human I (PS) have found it entertaining that robots that have been set to learn how to converse by engaging with Internet conversations and the implicit assumptions of language have had to be taken off air because they rapidly develop extreme racist and misogynistic forms of speech. More practically, apps like MyChat (from China, with over a billion users since 2012) allow many different forms of individual and group conversations between people.

We hope that this first volume in the EFTA series will encourage therapists, supervisors and trainers to look more widely for inspiration both within our field and in other disciplines. For example we have already discussed the importance of creativity and Maurizio Andolfi calls creativity and playfulness “magic tools to produce change”. So a final area we might draw on is that of studies of how creativity can be potentiated in the therapeutic and supervisory contexts (Stratton and Hanks 2016).

Conclusion

In this chapter we invite you, our reader, to use this book to consolidate your originality in thinking and practice. We hope that many of you will offer your achievements within the supportive context of EFTA so that our profession can continue to develop its contribution to the wellbeing of individuals, families and communities.

With people such as our authors and the current members of EFTA active in our field we can be optimistic about the outlook for family therapy and systemic practice and confident that we cannot predict which directions it will go in future.