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The Systemic Model
The Systemic Model
some are more "true" than others, as this .case _6hol,-~_11t_e ,t.1i).an
.. ... ,__ :;.... !·•· - · ·-~ '. ~ ~ ~
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group handles this issue by citing the Ox/ord Engfish .Dú-iiun:z,y. ....·b.ich •t
1 defines a hypothesis as "a supposition made as a basis for Te.:1.Sjaj_rig,
without reference to its truth, as a starting point for an in v~~iga -
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tion." This immediately sets an intriguing framework aroun(\ther- d
1 apy--each case becomes an experiment of its own, a real-lif~mys-, ;
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! supporti,·e arran gerrie~t. Oné has to see a process in which activities
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,._ as rhythmically as the inhaling and exhal-
dove tail w ith each other
1 ing of brea th, or the systole and diastole of the heart.
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¡ What goes into al.intervention or a prescription is never com-
1 pletely the same as · 1 hypothesis . The hypothesis respects the cir-
,, -~ -. ..
cularity of family eyénts as far a~ possible. When translate~ _Jo a
Pr:!S~rip..!_ion, a lineaJ episte1!_1C>!~gy~~~avojgªbjy _adop~_. This
linear interpretatíon_ of the data presented by the family usually
reverses the f amily's version, introducing a new "punctuation" into
the family . The farriily may say: "So-and-so is to blame for our
misery by his insensitive behavior." The team says, "We see things
differentJy. We see your son not as insensitive but as extremely
sensitive." What will follow is an explanation of his distressing or
destructive behavio!.. as crucial to the welfare of someone, or as
confirming the unity of the family, or as a solution to a dilemma
brought about by sorne shift in the family.
Is this linear? In a way, yes; in a way, no. I prefer to replace the
concept of paradox _with that of polarity. In the 1-Ching, or Book o/
Changts, the meaning of each hexagram is modified by the inclusion
of an opposing possibility. In the same way, by replacing the linear
punctuation of tJ:t~-~ -f!li!Y_~ _ith an op_p_osite_qne _th,a.!_j_~~_qua_li_y
~ ~ E _group creat~a. polarity. The essence of polarity
1s an interpretation that moves from one pole to another, neither
true in itself but only in combination with the other, and always
suggesting other, unforeseen possibilities which are never spelled
out. When a f amily respond s to a reverse punctuation with a rejec-
tion not only of the p un ctu ation but of the behaviors it describes,
• and discovers a compl etcly different way to organize relationships,
one feels that this met hod of therapy . could indeed be called a
dialectic of polarities.
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I a f 2mily t'\"Oh-es new pattems in ada pti~g_to _:~.:!-~png c~rc-~m_:_
; stances. A beha\·iqr:.,__no matter h ow semeless or destrucfr(·e, is ·a1 -
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in sorne
- - -=- - --=-=------- ----
sense a soluti on . A di lemma arose at sorne poinf in
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1 the f amily trajectory 'when the natural processes of growth or an
accidental shift required a change in f amily organization. A symp-
tom can be a solu ti on of sorts . A good hypothesis will often describe¡ ·
a syrnptom, or any irrational behavior, as an ingenious solution to
the difficulties faced by the farnily on its evolutionary path.
An exarnple is another North American f amily the team saw once
for consultation; the family's problem was a beautiful, prorniscuous
daughter of twenty. The family consisted of the girl, her parents,
anda thirty-year-old half-brother bom of the mother's liaison be-
fore she met the father.
In the interview the team noted the constant hvinning ben..,een
mother and son, who both seemed very melancholy and even wept
in tandem. By contrast, father and daughter were loud and lively;
they fought constantly but in an amiable, aff ectionate manner. The
father and mother were distant in the session, but the children
reported that the father would often criticize the mother, who
would then cry. The problem dated from the time of the son's retum
from the Vietnam War. Quarrels and 6.st fights between son and
stepfather led to his _panishment toan apartment below, where he
lived like a herrnit. Soon afterward the daughter, then in her early
teens, began to go out wíth men, with the apparent knowledge of
the mother, who deplored her behavior on the grounds of safety but
insisted on knowing all details. If the father tried to scold or control
the girl, the mother protected her.
The hypothesis of the team was that the girl's behavior kept
dangerous couples apart at the same time that it prevented them
from separating. The girl's behavior distanced the girl from her
father because of the quarrels it set up; it distanced her mother from
the half-brother because her mother was so preoccupied with her;
it distanced the mother from the father because they kept fighting
about how to manage her; and it distanced the two men because the
mother's preoccupation with the girl kept the son out of a rivalry
with his stepfather that would otherwise have surfaced. The behav-
ior also kept the family stuck together in their attempts to deal with
it. 1
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. . r v u ;, ¡J A 1 1,J l\::, 0 t I AMI L \ ¡ h ¡. ¡..A¡, \'
i,- s0 that he can be r ~e,ent in the farnil\' and w0uld n0t he -ut off · h .
a fs .i¡ -~n fice; she give~ up her ad0lescence· to go out and lead ; cert ~/n~ k~n1ds
o 1te . ·
. s.: S~e is d_o ing like her brother-maybe forever . But we havt: se
DR .
in ou· expe ne nce in \fl1 - en
. '. d · " n many, many, many heautiful voung girl s in this
s1tu at1 on o the same for the father . So . . . 1nsing
. . t o go
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FA 1HER : So you mean I'm the bad guy [Laughs .]
DAlGHTrR : Depends how you see yourself. !Gets up .)
FATP.ER : I don't see m yself as anything.
DR . B.: _! standing] D ., you have really been doing a Iot for your father
-the sac_nfice that you make for him so he can be present in the family
-and th1s can go on for ali your life, as we see in many cases ...
DR . s.: !talking over] You insist on this-not to be excluded from the
rapport between mother and S.. . .
DR . B.: . .. is our conclusion. [Farewells ali around .]
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.-\s;.0ciates describe their dforts to count eract the inílu ence of this
kind of person, who is often the one who referred the family to l
therapy ,rnd who may have an ernotional stake in the outcorne of
t~Ea tment .10 Often the team v.-ill ask such a person to attend the
session. They add: "1\"e no !mzgrr maJ:r the mi,fakr vf ad,ri;i ng or pmrribi,,g
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ri.r inlerrupfi(ln o/ the rdarionsl: ip b,:-iJ..w n the _/¡¡mil_¡¡ and thr referring prr_:;.011. " ll
Instead, they sirnply prescribe the situation. The farnily is told that
it must not hazard any movement toward the change it desires
because if the symptom were no longer present, the family (or sorne
particular family member) would lose an important friend/ ally / -
cornforter. Alternatively, the team will prescribe the presence of the
professional as essential to maintaining equilibrium and preventing
a premature change.
The Milan Associates ~ -th~..D any_Q.tb_er gro!,!P. a_b_out
giving p~rity to contextual issues of treatroen_t, especially those
pertaining to the professional field . lf the family refuses to come to
therapy at the time set, or if a member refuses to attend, this will
take priority for the team, no matter how serious a problem the
family may be presenting. They will either postpone therapy untü
the family agrees to their terms, or will address the issue in the
intervention, which will usually prescribe that the farnily continue
to behave in that particJlar way to prevent change. Sometirnes, as
we see, the question of the interfering professional may be the total
focus of the intervention . This stance insures freedom of movement
and is in part responsible for the extraordinary leverage the group
rnaintains at all times .
Circular Quesfioning
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am0unt and qual ity of information that comes o'ut in an in_terview .
The basic tenet is alwa,yJU..o ask guestions that adqress a diffe.r~e //
or define a relati onship.., Asking someone to comment on his·parent's
rnarriage, or to rank f amily members on the ba sis of who has suff-
ered the most from someone's death, orto rate, on a scale from one
to ten, his mother's _and then his father's anger when his sister
comes home late at night, are ali "difference" questions. So are
questions that deal with before and after: asking a child by what
percentage the fights between theparents have diminished since the
o]der brother was hospitalized, or posing "hypothetical" questions
such as, "If you had not been bom, what do you think your parents'
marriage would be like by now?" or "lf your parents were to di-
vorce, which child would go to which parent?"
Using this method, one notices severa} things. First .of all,
questions make people stop and think, rather than react in a stereo-
typed way. The people who are not talking also listen attentively.
Second, these questions cut into escalations and fights, not only
between family mernbers but between a therapist and farnily mem-
bers. And, third, they seern to trigger more of the same kind ·of
{Í "difference" thinking, which is essentiaH~. circular because it in-
/ troduce_,s._th_e_jdea-0f--lin s...ma~ .¿p- ~ sfiiftin~- pers~ectiv~s. The
/ Milan .f\ssociates point out that in families in schizophrenic transac-
tion people seldom define a relationship or notice a difference, and -
that this technique used alone may have a powerful effect on these
families.
The questions may have a cumulativ'e eff ect. One might ask a J/
wife what kind pf relationship the husband had with his mother,
and then ask him the same question about her and her mother. This
cross-referencing of information can be revealing and can lead to
even more revelations. In addition, the therapist can use this tech-
nique to ask quite heavy questions without the usual constraints,
since he is only getting the opinions of others. The Milan Associates
will ask even young children what their opinion is of their parents'
sex life. Since children always have an opinion, this does not in fact
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make thern privy to information they should not have. And despite
the horror of family therapists who have been drilled to make each
family member talk only for him or herself, my sense is that in an
indirect way these questions push people to differentiate quite as
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much as ask ing peop ic directly to do so . For in ~tance, the u-;ual
response of p.1:ents and chiidren to the question .about sex seems to
reinforce the gcnerati on line, not blur it.
Another u~e for the;e guestions is that they can be used to block
behaviors by simply po inting to them. If a mother has a "dea th
phobia," the team may ask the father: "What do you think wouid
be the effect on the f amily if Mother died?" This puts the "worst
case" on the table and takes away from the death phobia sorne of
its old pov.:er to upset others. In the case of an attempted suicide,
.for instance, one might ask: "lf X had managed to kill herself, who
in the family would be the last to forget her?" And so on. l
In general, it seems that the Milan Associates now have a~ elega~t
rnodel for conducting the interview that is congruent w1th their 1
Batesonian philosophy of treatment. Both the interviev,.ring tech- J
niques and the systemic intervention at the end insert punctuations
that ernphasize difference and circularity. The questions reinforce
and are reinforced by the prescriptions derived from thern in a
manner that makes the entire interview an example of circularity at
a more complex level than if either technique were to be used alone.
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-:- th: r0\•,er ~ amil ies to rend er th rrarists impotcn t. J.n d they pl ace
: H·.: hniques for maintaining lenrage above any othcr pra&matic
\ .,ch ienment. To this end, they ha ve adopted a number of devices
t!B t help the therapist or the team to stay in a position from which
max imum change can be achieved .
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In it~ ~implest form, the Milan Associates describe ~ ,, as \
the ab1bty to escape alliances with family members, to avoid moral
judgments, to resist all linear traps and entanglements. lf, for in-
stance, no one member can say after.a session that either therapist
sided with him or her, "neutrality" has been achieved : "The thera-
pist can be effective only to the extent that he is able to obtain and
maintain a different level (metalevel) from that of the family." 13
I would add to this many of the other devices and methods the
team uses in its approach. For instance, what strikes an observer of
the Milan Associates is their deliber~e use of l!!Y-S~ry and drama.
The family knows that people are silently watching from behind a
screen, not just as observers but as active participants. The thera-
pists in the room come and go for mysterious reasons-sometimes
c;m impulse, sometimes in response to a knock at the door.
In addition, team members-even those in the room--cannot be
influenced, because they are controlled by invisible others. One is
reminded of the old-fashioned analyst with his impassive position
behind the couch. Messages- and letters that emerge from behind the
screen reinforce the notion of the one-way street. The attitude of
the therapists toward family responses, always moving with them
or rernaining unmoved, rather than joining in outright battle, is also
. " neutra.l"
a way to remam .
~position fit~th the ba_s.ic tenets of strat~gic _therép..Y_: Unlike
the therapist who pushes and pulls the fam1ly mto shape, the
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"bullfighter" therapist, one could call these practitioners "hen-
house" therapists: "Ain't nobody here but us chickens." These ther-
apists take a low profile, speak softly, and carry a tiny stick. Like
Tudo experts, they use the rnornentum or ilie farnily 's own resistance
to effect change.
Toe surprising thing, for th ose who begin to work this way, is the )f
power of the approach. I have sometimes called it the Therapy of
the Weak, since the force seerns to come from the very negation of
using force. Shakespeare, in one of h is most farn ous sonnets, de-
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$Cil--. e5 a lon:~ too coc,l e\-cn to notice hi~ 0wn influen ce 0n the heut ¡
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of the Ba:-d : ".rl.e fr.., t h.1th p0\,·er to hurt .md ,,;ill do none / That
,,·ill n0t do t'h.1t which he most doth show. " is-to paraphrase the !
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embittcred .md loYesick Shakespeare-a much tougher custome:r
th .:.n YL"'Ur en'ryday activist. In f act, he has ali the cards in his han d.
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''Nrutr.1.lity" confers on the systemic therapist the pov·,er to be
eff ectiYe. But the ingredients are many: the quiet, nonreactive
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st.ance; the circular questioning, always placing the ther..1pist at the
metalevel ; the devices that prevent the therapist from being endan-
gered by family suction (the screen, the team, the messages, the
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unexplained and unexpected words and actions of the therapists); '!
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the concem with field and context issues in order of priority; and
finally, the implacable atbtude toward resistance. The team will
sooner lose a family than insist on change.
In ending, let me cover myself by saying that by the time this
book is c,ut, this chapter may be obsolete. Toe ?\1ilan Associates'
work is always in process always chaN~!~The group is now
moving in very d iff erent directions than they did when Paradox ,u.d
Ccur:trrparaicx w~s published. The_two men, Boscolo and Cecchin7
are teaching in Milan and traveling extensively across Europe, Can- ·
ada, and the United States, giving workshops. Selvini and Prata are
also· teaching, ·mainly nciw in Europe, as well as continuing with ,"
their research . The group is coming-up with very different clinical
instruments than before, and as they are now in rnany ways two
teams, not one, it is to be expected that diff erences will develop
between them, as well as between them and their ever more numer-
ous followers.
\tVhatever happens, the Milan Associates have given us not only
a pragmatic expression of a tnily circular epistemology, but a new,
more finely tuned apparatus for assessing and working with difficult
farnilies . In addition, as the next chapters will show, this method
raises rnany novel and interesting clinical issues. And these issues
in tum lead us back· to a more rigorous look at our theoretical
frameworks and the epistemologies that support them.
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