Sunday, 7 October 2018

Systemic Therapy With Individuals Hedges


Contents
Chapter 1: Introduction    1
Chapter 2: Overview of systemic therapy and practice    1
Chapter 3 Social constructionist approaches to emotions and self    3
Chapter 4 The importance of context    5
Chapter 5 From neutrality and curiosity to self=other reflexivity    6
Chapter 6 Circular questioning    7
Chapter 7 Hypothesising and Systemic Story creation    9
Chapter 8 Future dreaming and appreciating abilities    9
Chapter 9 Tracking an Episode    10
Chapter 10 Change: an ethical stance    11

 

Chapter 1: Introduction

What meaning does the client give to the others behaviour and all of their interactions
There is no definitive explanation, we are born into a cluster of stories, we are in a cluster of contexts
All relationship happens in a context
Difference =knowledge, difference presupposes relationship

Chapter 2: Overview of systemic therapy and practice

Make sense of the ecology of the system, the meanings that are given how everything fits together and the communication patterns that evolve.
Cybernetics: systems are complicated and self regulating
So one person gives feedback, it is received by possibly many people each giving their own meaning to it.
Explore how come people come to be described as lazy, depressed etc, something that represents an internal state.  These words represent how we communicate, behave to other people not an internal state.
When people describe themselves with an internal state, what brings you to say this and what effects does it have on other people.
Questions find about clients’ meaning, statements tell the client what the therapist thinks and feels
In science there is cause and effect, one billiard ball has energy that knocks into another and causes transfer of this energy. If you kick a dog you never know how he is going to react the energy is with the respondent, cause and effect are inverted
Bowlby: there is the assumption in mental life that some kind of energy is at work, as this is how science works, Freuds hydraulics but this has been discredited
Language is linear, and suggests linear causality, it has subject and objects. Language is descriptive, static and linear and living systems are dynamic and circular.
When we think we have an explanation we give up looking for other descriptions
Avoid linguistic tyranny by replacing the verb to be with to show

So to describe not explain
Terry calls me lazy, what behaviours do you show that lead terry to say you are lazy, would other people agree, disagree, what would you call untidy, has your tidy\untidiness changed, how would other loved ones describe your behaviour
These questions show that words like lazy are descriptions by someone within a relationship not an inherent quality

Positive connoting;
Problem with eating is a problem with your relationship with food, what are other important relationships that you have what is the type of relationship like, the pattern of communication. Positively connoting is to work out how the problem, makes sense within the relationship.
Cause and effect someone is to blame
Relational effect no-one is to blame

In a systemic orientation we work with the idea that every action is a communication and every communication is an invitation to other people to respond in some way.

How do others interpret her behaviour and how do they respond.
So positive connotation understands how a behaviour is helpful to the system, the logical connotation works out the maintenance, what keeps this going.
No-one can change easily under a negative connotation, e.g. blame

‘everybody is doing the best they can, given all the circumstances.’
Hedges, Fran. An Introduction to Systemic Therapy with Individuals: A Social Constructionist Approach (Basic Texts in Counselling and Psychotherapy) (Kindle Location 530). Palgrave Macmillan. Kindle Edition.

First order cybernetics the therapist is the expert.
Second order cybernetics the therapist is part of the system.
Cybernetics=regulating system

What we hear in any communication ‘is in part determined by what we expect and want to hear . . . by the history of the relationship (and by the) . . . context’ (Watzlawick 1964: p. 66).

Chapter 3 Social constructionist approaches to emotions and self

Meaning is constructed in relationship, we may have broad agreement with groups we belong to about the meaning of  certain words but they may take on a more specific meaning within our family.
Wittgenstein we find the meaning of a word through its use, the meaning of a word is like family resemblance it contains a range of definitions.

Emotions=Seen in our culture as internal, private, abstract, primitive, and belonging more to women than to men,
Hedges, Fran. An Introduction to Systemic Therapy with Individuals: A Social Constructionist Approach (Basic Texts in Counselling and Psychotherapy) (Kindle Locations 664-665). Palgrave Macmillan. Kindle Edition.

Emotions are culturally and historically specific
Different types of emotions around the world, 5 types of anger for instance. In the 17th century emotion meant agitated behaviour of the crowd, then in the 19th century emotions had been feminised and men didn’t have any emotions


If we accept that emotions are socially, historically and culturally constructed we must explore the specific stories, communication processes and contexts in which our clients have developed their ways of feeling.

Hedges, Fran. An Introduction to Systemic Therapy with Individuals: A Social Constructionist Approach (Basic Texts in Counselling and Psychotherapy) (Kindle Locations 721-723). Palgrave Macmillan. Kindle Edition.
Emotion: who is communicated with and what is being said, and what request is being made.
When taking a self opinion, who would agree with you, who would disagree with you. You might also ask what comes to mind when you have your self opinion. So what story is it part of? When do you feel most, this self opinion?

Emotions aren’t abstract they are actual moments of feeling and expression
Averill=emotions are short lived experiences
Emotions are reified, we get beguiled by language, I am angry
Emotions are discursive acts
The way to understand emotion is
1.       Bodily sensation
2.       Characteristic display
3.       The words we choose to describe the emotion
4.       The social act( communication)s
Bodily sensations
Some emotions are seen as stronger when they have a stronger bodily sensation, e.g. anger, anxiety, but some emotions have no bodily sensation e.g. hope. Some bodily feelings e.g. tiredness aren’t an emotion. Anger and love are emotions that are described as controlling behaviour.

Contextual rules
We learn ways of behaving with our emotion in different circumstances, indeed how we display in a certain circumstances adds to the meaning of the emotion.

Words we choose to describe the emotion
This says what the behaviour and physical feeling expresses, we are interpreting what we did and feel and expressing it to another, or to ourselves
Social act
What is being communicated by the emotion and who I  communicate to
Our emotions come in episodes that have beginnings, middles and ends.
You can think of association in terms of family resemblances, this resembles that, so this comes becomes experienced at the same time as that.

A family resemblance doesn’t mean one thread connects, but rather in the overlapping of many fibres.  What this means is that there isn’t a thing called anger, but rather family resemblances between different anger incidents.

We are born into an arena with conventions for certain situations.  So as we speak, we speak on the basis of previous utterances, and speak on the basis of what is expected in a certain situation.

When someone says they had to do x,yz, this usually indicates a rule being followed. So an emotional expression has global meaning in terms of it being learnt and talked about within a society and has a local meaning in terms of how it was talked about within the groups that the person is a member of.  Asking what certain people think about his expression shows these various positions, so someone in your society, someone in your family, your partner.

Our self is created with culture, race, gender, etc. It creates expected patterns of conversation and behaviour. Patterns of conversation within various groups produce the self that we know ourselves to be.

Gergen:
Three views of self
Romantic: hidden depths, mystery, passion: meaning, love, inspiration
Enlightenment: rational, fixed, knowable, consistent
Post modern: multiple selves and contradictory  , continuous construction

Japan has 260 ways to describe social relationship, leads to a richer sense of self.
Self in UK, come from a Judaeo Christian idea, about moral agency, social responsibility and obligation. A network of obligations and commitment.
Language gives us the sense of agency and it reduces to our sense of identity, I did x, because I’m that kind of person. I cause I am responsible for something.
The position we occupy in the world, leads us to feel certain emotions and creates our sense of self.

A position is a set of rights, responsibilities with respect to what one may say in a certain context. You don’t need any intra psychic information to find out why someone acted the way that they did.
Social factors determine what discourses we can join

Chapter 4 The importance of context

Words only have meaning in context. Context is therefore key to a social constructionist approach.
There are no universal meanings, rather than we are given certain meanings, that we then adapt in our local experience, and re-use differently in different context, although there is a family resemblance.  Context is the process of weaving together of words.
In certain contexts I connect to certain stories about myself, there is a family resemblance to me in meetings, or me as a therapist. Etc This then leads to ways I may think, act and the like.
We are never in one conversation, we are in the nexus of many conversations. Each with its own meaning and action.

3 contexts that exist within a therapeutic conversation
1.       Context of Time
2.       Context of Place
3.       The context of the definition of a relationship
We use context markers to indicate what conversational context we are in:
The welcoming noise about weather
The starting of session, the sitting down, looking directly, asking how you like to use our time today
The ending of session,  that’s about all, the getting ready to leave to toom.

We simultaneously act out of a numerous contexts and into numerous other contexts that we imagine, invent
Multiple contexts
Moving through different contexts with someone changes meaning, can cause misunderstanding without clarifying the rules of engagement, but can allow creativity.

Chapter 5 From neutrality and curiosity to self=other reflexivity

Milan groups 3 principles: curiosity, circularity and neutrality

Neutrality: not accepting  one position as more true than another, so you can never be neutral but if you continue to generate new interpretations then this is demonstrating neutrality as you don’t think your opinion is the one
Neutrality was originally conceived of by the Milan team as seeing that everyone in the system is doing the best they can given the circumstances.  This was used as an idea to prevent the siding with anyone member of the system as this shuts down curiosity.
First order cybernetics easy to pathologies, blame, and be punitive. The biggest challenge is to see things not from your clients point of view but from others within their system.

Asking what would bob think if they could see you, gets other points of view, this can help provide further information, can provide how this may affect the relationship between bob and Mary
So you may want to ask questions about people involved with the thing which shows systemic effects, you may want to ask about how other people would see things, which can generate other ideas and perspectives and can help restructure and connect with the clients own thoughts.
Whilst being neutral, exploring areas the client or you think are unjust seems helpful.

An invitation to curiosity
Being curious allows us to connect to different explanations and not to get stuck. Curiosity is perpetual doubt so could be destabilising, helps empathy and understanding. Its very hard to change when you’re held to blame

Showing irreverence to our prejudices.
We can never be free of prejudice. Prejudices are like heat seeking missiles that home in on models that confirm pre-existing beliefs about the world.
When clients are stuck we are too wedded to our own prejudices

Irony to the discourse
Instead of neutrality, critique the theories that you are using whilst you are using them.

Reflexivity is that which turns back on itself, which takes account of itself.
Notice how you talk in public about your client and also in private, but will determine how you re open to them.
Use reflecting team principles to generate ideas, you can take themed team members what would the psychiatrist say?
The fifth province is a place where you can say the unsayable and think the unthinkable, it was original a place where Celts and druids could work through their differences.

Chapter 6 Circular questioning

Circular questioning allows us to enter the interpersonal systemic frame
Looking at the internal world separates you from your relationships.
Family is the crucible where we generate our identity and learn how the world works.  Its also the most powerful system of which we belong.
Genograms help explore relations, myths, and possible connection to personal identity.
Genogram
Who is closest to who, what similarities and dissimilarities do you have. In a genogram there may also be connections out to not physical\biological entities.
Timelines help you notice when and with whom you feel happier or less happy, close or less close.
You can make connections and distinctions between how you and significant relationships view the present, future and past.
Questions you can ask would be how does the change in relationship change how you saw yourself.
The language of relationship, is the language of patterns, not what is. This helps make sense of how a person responds in certain conversations, contexts and sequences of action.
Interpersonal relationships are feedback loops which have a certain pattern and certain information.
We think within person due to psychoanalysis relationship with science and the way language is constructed.  A relationship is a feedback loop. To be part of a relationship things need to be observable as they count as either behaviour or feedback, both critical for relationship.
Information is difference, difference is relationship

To get more information you change relationship, so you touch a sport then move your fingers around it to get more information.  When things change, what sense do you make of them.
Difference creates meaning and to have difference you need to have one thing relate to another, e.g. quiet
Circular questions target perceptions of difference not facts.
Absence can be a communication, silence is a communication, we cannot not communicate.  Language is linear, life is circular and dynamic.
Language is linear as you have subject and object, cause and effect, before and after. Its clean and a singular in direction.            
To avoid linguistic tyranny replace the verb to be, with to show or seems, appears . What we say about a person is a function of a relationship.
How do you show your sadness
What would your tears say
Who do they most want to say this to
Who notices what is shown. What is it like for them
Punctuation
In a long sequence of events, then people add punctuation to make it seem, one persons leads, or is in charge, or independent, to shape the direction of the interaction, active and passive.  However this punctuation is arbitrary in terms of before and after, cause and effect.
Disagreements as to how to punctuate is the cause of many disagreements. X caused it, y caused it

To an observer they might see a series of interchanges however to the members of those interchanges there is punctuation and a web of expectation of others behaviour.

Stimulus and response depend on looking at short interactions but if you take a longer perspective everything is both stimulus, response and reinforcement.

Chapter 7 Hypothesising and Systemic Story creation

You should hypothesise on the basis of your clients presentation. Everyone basis their engagement with the world on a hypothesis. The worth of a hypothesis with a client that it creates a resonance for those involved.  Although it does seem from the multitude of description and complex reciprocity that a hypothesis veers in the face of description towards explanation.
Hypothesis draw from four sources
1.       Data
2.       Theory
3.       Therapist experience
4.       Personality (Personal givens)

When we fall in love with our hypothesis we stop being curious.
Exploring neglected voices, what would they say about x, enables you and the client not to fall in love with particular theory.
So whilst there can be multiple hypothesis that can fit a story you cant get all hypothesis to fit a story, some are not helpful.
Hypothesis must be helpful and appreciative
A good hypothesis should produce news of difference.

In the not telling who are you protecting from your feelings.

Chapter 8 Future dreaming and appreciating abilities

The future influences more the way . . . we live in the present than anything that happened in the past Lang and McAdam (1997)
Imagination is more important than knowledge Albert Einstein
To have no possible futures is to be impoverished.
The end forms the present and does not purely reside in the future.
As you prepare as an archer, or a house builder you are led by how you want things to be.
Problems can be frustrated hopes and dreams
Explore the desired future and how problems are getting in the way of that.
When working with the future it is easy to show the deficiencies in the past and present so rather you need to build on the best of what is.

Future orientated questions can enable clients to produce\engage with possibilities for the present

What if you did know as a counter to I don’t know, as it can attach the client to knowledge they have but haven’t considered.
Fixed rule language games=chess, playing it reinforces the rules
Dreaming conversations create worlds of imagination that can be walked into.
A goal that has a stop command usually has a negative connotation in it, so stop stealing=thief, strong being anxious=weak, stop being angry=nasty. What kind of future do you want.  What would your dream of the future look like?
As you imagine the future, then look back from there to ask what did you do to help you get there. Alternatively what helped you get there, who helped you get there.

As you looked back what skills helped you get here, maybe skills you didn’t realise at the time.
Future work can be used with complex issues

Chapter 9 Tracking an Episode

When you talk about something being deep in your life, or a deep issue, you are talking about your relation to it, it has many complex links, it is related to the past
Stories and making sense of things. When we think\understand something this can be an outcome of personal, cultural, family, gender stories about what happens, or should happen.
Every metaphor is based on a model.
Metaphors, hold theory, hold fixed ways of seeing the world
Clients talk in many languages, words, tone, body, behavioural…
When we are in conversation with another we are playing a guessing game, what episode is happening here, what is going on here, are we playing the funny game, the supportive game, the moaning game etc. Likewise the personal meaning is significant if we are arguing if we stay together, then this episode was a bad patch, if we don’t stay together then this is indicative that we should break up
Disagreements about how to punctuate are at the root of many couples disagreements. Punctuation means taking the mass of events, and adding cause and effect, adding in episodical information. Punctuation lets us make sense of the complexity
The constituents of an episode are time, boundary and structure. Time is when an episode starts and ends, boundary is what’s inside and what’s outside and structure is what’s the pattern of the episode, the story if you like.
Scripts are the patterns that we receive socially, difficulty can come when there are script conflicts and also script conflicts with  our own personal goals.
Every episode has multiple layers of context, multiple stories that make sense of it, multiple frames.
A URP is an unwanted repetitive pattern.
There is both a grammar of language, how to put sentences together ,and a grammar in living of how emotions and behaviours and rules go together.
The substance of our social world is moral, we act as we think we should, how we think is right.
If someone says they couldn’t help themselves then this is the sign of deontic logic, a moral force of what should be done is at play.
RAC has a clash of two systems, what should be done in terms of behaviour and what I should do in terms of response, leading to frustration.

Chapter 10 Change: an ethical stance

How do you stay with the client and yet be with their desire to change
Therapists are looking for big change and miss small change, therapists can notice stuckness but not notice change.
When a client resists a therapists then the therapist is pursuing their desires not the clients.
There are 3 aspects of therapeutic change
1.       Emotions
2.       Stories
3.       Behaviours
No story is complete, there is an infinitude of the unsaid, of possibilities
What we mean by information is difference that makes a difference
Change happens when you introduce an idea that is not too similar and not too different.

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