Abstracts - Zusammenfassungen
Plena - SP01-05 - SP06-10 - SP11-15 - SY01-06,14 - SY07-13 - SM01-06 - SM07-13 - SM14-20 - SM21-27 - SN01-05 - SN06-10 - SN11-15 - SN16-21 - SN22-26 - SN27-32 - SN33-37 - SN38-43 - P01-13 - P14-28
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Seminars Afternoon - Seminare Nachmittags
Friday - Freitag, 1.10.2004, 14:30 - 16 h
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SN27: Technical Issues in Systemic Therapy (Technische Fragen Systemischer Therapie) - English
Matteo Selvini, D. Fabrizi, S. Ferraris, A. Penna (I):
Family Secrets (Familiengeheimnisse)
To discuss the state of the art about how to consider and how to deal with secrets during an individual and/or family psychotherapeutic treatment. Ten years ago Matteo Selvini published a study about 42 cases of family secrets observed in the clinical population of his institute (Segreti familiari: quando il paziente non sa, Terapia Familiare, 45, 1994. – Family secrets: the case of the patient kept in the dark, Contemporary Family Therapy, n° 19, 1997; also translated in Spanish and French). The presentators will present the data about family secrets observed in the last ten years in the clinical and research population of Mara Selvini Palazzoli’s institute.
A specific attention will be given to secrets concerning paternity. The basic ideas will be illustrated with a clinical example.
May Michielsen, Wim van Mulligen (B):
Training Professionals in Multidirectional Partiality for the Future of our Children (Training von Professionellen in vielgerichteter Parteilichkeit für die Zunkunft unserer Kinder)
In The Netherlands and the Flemish part of Belgium there is very much interest for training in contextual work among professional helpers in children and youth care: group leaders, social workers, workers in foster care, etc. The concept of multidirectional partiality is recognised as very helpful and is experienced as a big challenge, especially for those, who take care for the child on a regular or daily base in situations of neglect and maltreatment of children. I. B. Nagy taught us that a position of judgment or moral indignation and protection of the child leads to a loyalty conflict for the child and mistrust in the relationship with the caregiver or helper. Multidirectional partiality asks for a real change of paradigm and for a training that is not only cognitive, but also relational and emotional. It is a basic attitude and a skill. To obtain the attitude, a careful examination of the own context and considering the possibilities of deepening the dialogue with that context are the only way to integrate it in ones hart and soul. To obtain the skill, consultation, practicing, role-play, supervision are necessary to learn to manage aspects of timing and setting and to speak a language that connects. In this presentation we explain and teach and try to give an experience of our teaching-program and the challenges and difficulties of it.
The Group Analytic Method of Supervision in Family and Couples’ Therapy (Die gruppenanalytische Methode der Supervision in Familien- und Paartherapie)
Objectives: A new method of supervision procedure applied on family and couples’ group therapy is presented. The participants of the workshop will be involved in the specific method through an emotional and interactive group procedure. Also the results of an ongoing research study, which is based on the quantative and qualitative analysis of 250 Supervision Protocols of multiple supervised activities, will be presented.
Reference:The workshop will refer on the Tsegos or the «Greek» group-analytic method of supervision (Tsegos,1986,1995,2002) which is focused on the relationship between a therapeutic group or a family in therapy and its’ supervising group. This relation includes the interaction between various persons such as the participating students, the presenter and the experienced observer, as well as the description of the therapeutic group and their mutual relations.
Conclusions: This network of interactions promotes the reflection of multiple mirror phenomena between the two groups (supervising and supervised) and facilitates the exploration, understanding and studying of many levels of interelations. It also facilitates the conjunction of cognitive and emotional understanding of the presented group session and provides the opportunity for personal growth and the strengthening of the professional identity.
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SN28: Issues of Couples Therapy (Paartherapeutische Fragenstellungen) - English
The Just War Theory as a useful Tool for Ethical Reasoning about the War of the Roses (Die Theorie des gerechten Krieges - ein nützliches Werkzeug für eine ethische Reflexion über den "Rosenkrieg")
Traditionally the couple therapist is supposed to listen, to speak, to handle from a neutral position. To discuss ethical questions when a couple is in the middle of a war seems not advised. Speaking of ethics is most of the time associated with a redundant lecture and suggests that the therapist might be pedantic person who overloads the partners with guilt feelings in stead of helping them.
Nevertheless we argue that a value-free model is not very useful for the practice of therapy with couples who suffer from reciprocal negative insinuations and accusations. We think it is not suitable to sideline the ethical reasoning in therapy with couples. We are inspired by Martha Nussbaum and Richard Rorty in our search for inspiring sources for ethical awareness and understanding in couple therapy.
Sue McNab, Ellie Kavner (GB):
Shaming Practices in Couple Relationships (Beschämende Handlungsweisen in Paarbeziehungen)
We will be exploring the way in which shame becomes embedded in relationships between couples increasing conflict and disconnection; preventing mutuality and feelings of being understood by the other. We will use clinical examples from a variety of problematic areas for couples e. g. impact of ageing, impact of chronic illness and violence, to illustrate our practice. We are working towards enabling different conversations than those silenced by shame through exposing how shame operates on a number of levels from individual bodily sensations to social/cultural discourses. When working with couples we are conscious of each person witnessing the intensity of the others accounts that may give new meaning to their shared experience. As self-reflexivity has become an important component of systemic theory, we have come to appreciate the relevance of accessing our own inner dialogues, both at a cognitive and emotional level and considering how these are used in the therapeutic work.
Alicia Moreno, Beatriz Rodriguez Vega (E):
Power and Depression: Women's Well-being within the Marital Relationship (Macht und Depression: das Wohlergehen der Frauen in der ehelichen Beziehung)
Objectives: The purpose of this research was (a) to evaluate the association between the power inequality within the marital relationship and women´s well-being (as reflected in their depressive symptomatology, and their diagnosis of depression), and (b) to compare the relative influence of the different dimensions of power on women´s marital adjustment and well-being. Design and Method: Two groups of married women (255 control, and 88 depressed patients) were given questionnaires evaluating psychosocial variables, depressive symptomatology, and various aspects of their marital relationship: marital adjustment, intimacy, power strategies, decision making, task sharing and a global measure of equality and equity. Results: Women´s lack of power resources (educational level and a being unemployed); the differential use of power strategies of both husband and wife (assertion, aggression, passive aggression, and submission); the imbalances in task sharing and in the decision making process, and women´s sense of inequity and inequality in their marital relationship, accounted for a significant amount of variance of women´s depressive symptomatology and their marital well-being. Some unexpected and clinically relevant differences were found between patients and non patients. Conclusion: Clinicians treating depressive or depressed women must take into account the power dimensions of the marital dyad. This research confirms the formulation of systemic gender-sensitive hypothesis that establish that depressive symptoms may be linked to a power struggle or power imbalance between husband and wife.
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SN29: Theoretical Frameworks for Systemic Practice (Theoretische Konzepte für Systemische Praxis) - English
Uniting Opposites through "Compasses" (Gegensätze mit Hilfe von "Kompassen" versöhnen)
C. G. Jung was fascinated by the wisdom that was hidden in alchemical writings and pictures. He described essential psychological lifephenomena as quaternities, that is as "compasses" where "north" and "south" express one duality, "west" and "east" another. The quaternity symbolizes the "Self", that is the psychic totality which through the process of individuation is strengthened by learning to deal with the opposites that belong to life regardless in what cultural environment you live. Another thinker, G. Bateson, wanted also to get away from dualism through a metaposition. This is not far away from the view of C. G. Jung (Wahlbeck, J. C. Mytiska och systemiska perspektiv. Svensk Familjeterapi 2/2000, pp. 1016). Both thinkers were influenced by old eastern philosophy, e. g. taoism and zenbuddhism. Using the idea of "compasses" you can together with your clients (individuals, couples and families) try to grasp the central themes of the discussions in family therapy. The "compass" model helps as well you as your clients to avoid the stereotypes that could lock your minds and narrow the perspectives cocreated.
Luis M. Neto, Helena A. Marujo (P):
After the Postmodern Fog: Optimism, Utopia and Critical Conciousness - at the Heart of Systemic Practice (Nach dem postmodernen Nebel: Optimismus, Utopie und kritisches Bewusstsein - im Mittelpunkt systemischer Praxis)
The authors teach family therapy and lead a range of programs on parental education in Portugal in the last 20 years. All of the sudden, a not entirely systemic book they had written on their spare time titled “Educating for Optimism” became a national best seller. This made the authors re-think the foundations of the systemic practices they were involved with. In this presentation participants will rediscover meanings in systemic thinking and practices. Objectives: a) To look back critically into the conceptual history of systems thinking in order to discern centres of variation, procedures and other focal points that made our practice more self reflexive, generative and acknowledged, b) To identify and characterize the most transformative systemic practices in the therapeutic and teaching contexts, c) To reflect upon how systemic thinking deals with socialization - involving media, school, peer and parents. Conclusions: We aim to arrive to a “phronesis”, an experience of a living theory. We will introduce our use of: “Virtuoso reframing”, “Unbewitching key words”, “Pedagogical reflective teams”, “Colombo’s questioning”, ”Hearing, Peter Lang’s style”, “Channelling the founding fathers”, “Palazzolian optimism”. Each of these links will be made explicit with the narratives of Wittgenstein, Cronen & Lang, Paulo Freire and H. Stierlin.
Structures of Development: A New and Evidence Based Systemic Approach (Strukturen der Entwicklung: Ein neuer und evidenzbasierter systemischer Ansatz)
There are two approaches to development: Epidemiology proves socio-economic factors, e.g. criminal offence, diseases, separation or parental death to affect the development of a child, while infant research offers methods for the observation of the individual maturation of skills. This meets the systemic view, since reliable resources improve interventional solutions for families.
Method: We propose a new model of development which integrates both perspectives: (1) Systematically assessing risk factors and resources allows an evaluation of the actual developmental status and leads to individual treatment objectives.
(2) The principles of intervention of the model are deduced from elementary notions: Life is a complex structure exchanging material, energy and information with its environment. Its systemic interface is the feedback unit of perception-cognition-action, which is functional for its purpose of self-determination, if it suffices the measurement criteria: The sharing of perceptive meanings (local objectivity) signifies attachment, temporal reliability of patterns of perception-and-action stands for resources and general validity of action corresponds to social responsibility.
Results and Conclusion: Attachment, resources and responsibility are the core processes of any pedagogic or therapeutic intervention. It has been shown, that on the level of feedback controlled perception the measurement theory is able to link the physical and the psychosocial paradigma of life.
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SN30: Therapeutic Relationship (Die therapeutische Beziehung) - English
The Client-Therapist Interaction and Empathy as Facilitating Therapeutic Condition (Die Klient-Therapeut-Interaktion und Empathie als erleichternde therapeutische Bedingung)
In the therapeutic process the client wants to be understood by the therapist, therefore the therapist needs to have an intrinsic empathising attitude towards the client and an adequate level of empathic accuracy (EA). Our study focuses on which variables cohere with EA of the therapist during the first session. Firstly, we examine the coherence between the therapist's EA and his physical attraction to the client? Secondly, the relation between the therapist's EA and the effort or motivation he expends in trying to understand the client is investigated. Finally, we examine the relationship between the therapist's EA and the meta-knowledge about his own empathic understanding. The standard EA-paradigm was implemented. 62 perceivers filled out a post-test questionnaire to asses (a) the degree of physical attraction, (b) a self-evaluation on the performance and (c) their motivation to perform the task. Self-report measures were administered. Statistical analyses included ANCOVA's and MANCOVA's. The results indicate that there is no consistency in the relation between the dependent (EA) and independent variables (physical attraction/meta-accuracy/motivation) over the different targets. The implications of the results for the therapeutic relationship and directions for further research will be discussed.
Marta Borges Pires, Débora Antoniotti de Vasconcelos e Sá (P):
Who Are the Co-Actors Starring in the Scene after all? (Wer sind eigentlich die Ko-Akteure in der Szene?)
“Why do the so called family therapy teams appear in different sizes and shapes?” The main purpose of this study is to systematize the different formats that have been used by family therapists since the beginning of the family therapy movement and, in order to understand if there are formats more adequate than others, to list the advantages and disadvantages of each. The analysis of the different formats (namely the one-way mirror, live supervision, co-therapy, among others) was based on a framework provided by Pina Prata’s1 Inter-relational Systemic Model. It was accomplished through three main criteria: the number, role and place in the hierarchical organigram occupied by each individual that belongs to the therapeutic system. The relevance of this study is emphasized by the existing lacuna in the reviewed literature of this field of study. In other words, neither a systematization of the different formats, nor a detailed list of the advantages and disadvantages of each was found. Therefore, we conclude that it is extremely important to develop research concerning this subject.
1 Pina Prata, F. X. (1981). Quantificação das interacções e qualidade das relações nos sistemas familiares perturbados, Cadernos 2, Terapia Familiar e Comunitária, APTEFC.
Aekaterini Theodoraki, Konstantin Batsalias (GR): Cancelled
When the Therapist is Withdrawing … (Wenn der Therapeut sich zurückzieht …)
The aim of this presentation is to explore in a multilevel way what happens to the family/therapist system, following the therapist’s short or long term withdrawal from the therapeutic process. Sooner or later, family therapists experience moments that they tend to withdraw, in contrast to other moments of activity and interest, in the therapeutic process. This state is important, challenging and reliable.
We are going to explore questions like: How does this tendency arise to the surface? What does it reflect about the family’s background, about the therapist’s background, about the family/therapist system history? Which process does the therapist pass through, while he is thinking about this issue? How does this “crisis” become valuable in therapy? How does this “crisis” influence the co-evolution of the family/therapist system? Through this process, the withdrawal is conceptualized within the place of its origin, it is connected with the therapeutic process and it earns value and meaning. We are going to present our clinical observations and discuss our related questions about this issue.
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SN31: War, Terror, and Oppression: Coping with Trauma (Krieg, Terror und Unterdrückung: Traumabewältigung) - English
10 Years After - A Study on Psychic Deseases with Female Refugees from former Jugoslavia (10 Jahre danach - Eine Studie über psychische Erkrankungen von weiblichen Flüchtlingen aus dem ehemaligen Jugoslawien)
Why now, 10 years after the war, so many women from old Jugoslavia do get sick. Depression and angst are the prevalent manifestations. These women arrived healthy , had no signs of trauma and now they are sick. A phenomenon which can‘t be ignored any longer. By means of some studies made by FEM South in Vienna the following items will be highlighted in brief. 1. The cause of the diseases and the symptoms, 2. Possibilities of treatment and the way there, 3. The importance of the investigation, especially for the psychosocial environment, 4. Which procedures are available to deal with this phenomenon in social and sociopolitical respect
David McGill (USA), Isolde de Vries (D):
Systemic Practice in a Palestinian Village near Nablus with Collaborative Physicians for Human Rights Mobile Medical Clinic (Systemische Praxis in einem palästinensischen Dorf nahe bei Nablus in Zusammenarbeit mit der mobilen medizinischen Klinik von Ärzten für Menschenrechte)
This presentation will describe the collaborative work of Israeli, Palestinian, Palestinian-Israeli, and international health workers in mobile medical clinics rotating to serve families in West Bank Palestinian villages. We will illustrate with a case of enuresis in a 12 year old boy treated by us with a systemic consultation, as co- therapists with a Palestinian Surgeon as translator. The family responded to a rather simple intergenerational differentiation consultation session, helping the mother shift from relating to the son as confidante for her "troubles" to retake a parental guidance role. The larger context for this "simple" problem and intervention will be explored: namely the lack of employment for the father and in-laws and the restrictions for all on freely traveling from the village over the past three years of the intifada, has greatly increased the pressure within families, the pressure between husband and wife, the pressure between mother and in-laws, the ability of parents to parent and of the generations to maintain differentiated boundaries.
Chana Winer (ISR):
Post-Traumatic Changes in a Time of Global Crisis (Posttraumatische Veränderungen in einer Zeit globaler Krisen)
The dictionary defines resilience as a “return to the original form after being bent, compressed or stretched”. This definition cannot hold true for families and individuals who experience trauma. There is no return to pre-traumatic, “original form”. No matter how resilient the traumatized family or individual is, the trauma will have a lasting, significant and meaningful impact in their lives. For professionals working with families, resilience is defined in terms of the family’s ability to cope with traumatic experiences and recover in a reasonably short amount of time. Various coping skills are employed by traumatized families and individuals in an effort to return to a life of meaning and connection. Clearly, inability to mobilize sources within oneself in the aftermath of trauma makes for a life of suffering for those traumatized and others around them. The price for those unable to cope with the experience of trauma is obvious to the individual, family and society. What is less obvious is the price of coping with trauma. Whereas the maladjusted can be found in therapists’ offices and hospitals, those considered well adjusted can easily be overlooked. However, lessons learned through traumatic experience are never forgotten, changing behavior, expectations and relationships. These are meaningful not only in the lives of dysfunctional families, but in the lives of their therapists as well.
The author will illustrate, through case studies, that in a world which is undergoing global crisis, post- traumatic consequences affect important changes in family patterns and behaviors not only for those suffering from PTSD, but also for those considered well adjusted and resilient.
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SN32: Networks and Network Intervention (Netzwerke und Netzwerkinterventionen) - English
Ricardo Ramos, Jose A. Rey, Mar Borrego, Peter Koo (E):
Therapy, Family and Network. Guidelines for Three-Party Conversations (Therapie, Familie und Netzwerk. Leitlinien für eine Drei-Parteien-Konversation)
The development of professional networks has caused that families attending to therapy without having previously attending to other professional services are scarce. As a consequence of that, therapy cannot longer be considered as an autonomous process apart from other expert contributions. The journey alongside the professional networks not only belongs to the family history but forms the conversation, which our intervention needs to rest on in order to gain efficacy. Pertaining to the Social Constructionism, the concept of Problem Determined System of Anderson and Goolishian, constituted a foundational approximation to the complications mentioned above.
Our team is currently working on the development of guidelines to give directions to therapists about the subjects to discuss with the families in order to:
a) the meetings will turn out to be relevant to the families,
b) the meetings will connect with the previous conversations,
c) the meetings will bring sufficient newness with respect to past conversations to promote changes.
We believe that a proper design of the meeting has to be based on pertinent subjects for the family, the therapist and the network. This design must be able to harmonize, on the one hand, the creation of alternatives recommended by the Social Constructionism and, on the other hand, the strategical scheduling of the meeting, unavoidable action for a therapist who seeks for an active change.
Regina Batista, Vera Celestino, Renata Dias, Ana Marques, Margarida Oneto, Joana Rodrigues (P):
Towards a more Reachable Family Therapy: the Importance of the Family Doctor as a Referring Person (Auf dem Wege zu einer erreichbareren Familientherapie: die Bedeutung des Familienarztes als Überweiser)
The presentation focuses on the importance that a family doctor may have as a person who refers patients to family therapy, which allows more people to benefit from this kind of help.
This process may be important to the future of psychology, turning it into a widespread practice.
In many countries, including Portugal, many health services (as is the case of psychological services) are still only offered in cities and towns. In the countryside, by contrast, only general medical care is available.
There is now a growing attention to the psychological practice. Doctors are more aware of patient’s complaining related to the mental health, and have begun to use the reference to psychotherapy as a working strategy.
Doctors may be an important referent for the access to psychotherapy for people who live or come from a rural culture, to whom there is no offer of mental health care, and/ or who ignore the existence and the utility of psychotherapy in general, and family therapy in particular.
Including the doctor in the psychotherapeutic system as a referent person may be an important approach for the future of a higher profile family therapy.
The importance of this dynamics will be illustrated by two clinical cases followed in the Centre of Individual and Family Therapy (SAFI) located in the University of Lisbon. These two cases concern two women from the countryside that reached our service through the reference of their family doctors.
Andreia Cardoso, Joana Ramos, Sandra Santos, Luis Miguel Neto (P):
The Emergenc(i)es of the Communitary Intervention: The CMM Perspective - (Kreativität und Krise in gemeindeorientieren Interventionen: die CMM Perspektive)
The Emergenc(i)es of the Communitary Intervention: The CMM Perspective - Das Erscheinen des Notfalls der gemeinschaftlichen Intervention: die CMM PerspektiveThe familiar system is very important to the professionals that work within the community. This communication aims to present an alternative perspective of the communitarian intervention centred in the family. We combine a theoretical and a practical approach by using real cases of disorganized families (Minuchin et al. , 1967) and their problems in the Portuguese context. Considering that all behaviour is communication (Watzlawick, 1967), it’s important to use a model based on it – the Coordinated Management of Meaning (CMM – Pearce, 1999) – to try to intervene in the community through it’s component systems: the families. This model (CMM) – that considers the existence of different levels – can reveal to be surprisingly efficient in the approach to the families if we articulate it with the Palazzoli’s (1980) idea that “what is dysfunctional at one level can be functional at the other”. In the actual context, the need to intervene became an emergency, so there is also a necessity for the emergence of Projects that really are efficient in the practice.
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