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IRREVERENCE

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Asen, E . , Dawson N . & McHugh B. Multiple Family Therapy: The

Marlborough Model and its Wider Applications
Bentovim, A . Trauma-Organized Systems: Physical and Sexual Abuse in Families
Boscolo, L . & Bertrando, P. Systemic Therapy with Individuals
Burck, C. & Daniel, G . Gender and Family Therapy
Campbell, D., Draper, R. & Huffington, C. Second Thoughts on the Theory and
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Campbell, D . , Draper, R. & Huffington, C. Teaching Systemic Thinking
Campbell, D. & Mason, B. (Eds) Perspectives on Supervision
Cecchin, G . , Lane, G . & Ray, W. A . The Cybernetics of Prejudices in the
Practice of Psychotherapy
Dallos, R. Interacting Stories: Narratives, Family Beliefs and Therapy
Draper, R., Gower, M & Huffington, C. Teaching Family Therapy
Farmer, C Psychodrama and Systemic Therapy
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Hildebrand, J. Bridging the Gap: A Training Module in Personal and
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Hoffman, L . Exchanging Voices: A Collaborative Approach to Family Therapy
Jones, E . Working with Adult Survivors of Child Sexual Abuse
Jones, E . & Asen, E . Systemic Couple Therapy and Depression
Krause, I.-B. Culture and System in Family Therapy
Mason, B . & Sawyerr, A . (Eds) Exploring the Unsaid: Creativity, Risks and
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Robinson, M Divorce as Family Transition: When Private Sorrow Becomes a
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Wilson, J. Child-Focused Practice: A Collaborative Systemic Approach

W o r k with Organisations
Campbell, D The Socially Constructed Organization
Campbell, D. Learning Consultation: A Systemic Framework
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Campbell, D , Draper, R. & Huffington, C A Systemic Approach to Consultation
Cooklin, A . (Ed) Changing Organizations: Clinicians as Agents of Change
Haslebo, G . & Nielsen, K..S. Systems and Meaning: Consulting in Organizations
Huffington, C. & Brunning, H . (Eds) Internal Consultancy in the Public Sector:
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Huffington, C , Cole, C , Brunning, H . A Manual of Organizational Development:
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 IRREVERENCE

A Strategy

for Therapists' Survival

in alphabetical order
Gianfranco Cecchin, M.D.

Gerry Lane, M.S. W.

Wendel A. Ray, Ph.D.

Foreword by
Bradford P. Keeney, Ph.D.
Professor and Director of Scholarly Studies,

University of St. Thomas, St. Paul, Minnesota

Systemic Thinking and Practice Series

Series Editors
David Campbell & Ros Draper

London
K A R N A C BOOKS
Η. Karnac (Books) Ltd,
118 F i n c h l e y Road,
London NW3 5HT
Second impression 1994.
Reprinted 2003

Copyright © 1992 by Cianfranco Cecchin, Gerry Lane, and Wendel A. Ray

The rights of Gtanfranco Cecchin, Gerry Lane, and Wendel A. Ray to be
identified as authors of this work have been asserted in accordance with
§§ 77 and 78 of the Copyright Design and Patents Act 1988.

ISBN 978 1 85575 031 9

AU rights reserved. No part of this publication may be

reproduced, stored in a retrieval system, or transmitted in any form
or by any means, electronic, mechanical, photocopying, recording
or otherwise, without the prior permission of the publisher.
A CIP catalogue record for this book is available from the British Library

Printed and b o u n d by A n t o n y Rovve Ltd, Eastbourne

CONTENTS

EDITORS' FOREWORD vii

FOREWORD ix

PREFACE xiii
ACKNOWLEDGEMENTS xiv

CHAPTER O N E

The idea of irreverence 1

CHAPTER TWO
Irreverence and violence 13

CHAPTER THREE
Irreverence in institutions: survival 31

CHAPTER FOUR
Suggestions for training 49

v
Vi CONTENTS

CHAPTER FIVE
Some considerations for research 63

CHAPTER SIX
Random closing meditations 73

REFERENCES AND BIBLIOGRAPHY 77

INDEX 80

ABOUT THE AUTHORS 82

EDITORS' FOREWORD

T he process of creating this book began when the three

authors sat down to share their thinking about some
of their more difficult cases. They discovered they had
similar views, their discussion was fruitful, and they agreed to
c a n y on the conversation the next time their paths crossed.
They met several more times, and found their shared ideas
began to coalesce around a concept they called "irreverence".
However, these clinicians do not work together, they do not
belong to the same research project, and they are separated by
thousands of miles. Instead they were joined by a similar open­
ness to new Ideas, and they were able to influence a n d be
Influenced by each other in such a way that this Innovative
thinking has become clarified for all to understand and put to
use. As editors we have been delighted to be part of this process
and to be able to bring this book to the reader.
This book is not a rationale for collecting different tech­
niques for use in difficult situations. Rather, it is an affirmation
that systemic therapists must always be on the edge, open to
new ways of seeing things and new ways of intervening; they
must always be prepared to say, "Yes, but there is another way

vii
viii EDITORS' FOREWORD

to see this". This ability lies at the heart of systemic practice,

and these authors have found a way of helping therapists stay
on the edge with even the most difficult cases.
We hope the reader will think of "irreverence" as the mile­
stone in the progression of systemic ideas that have emerged
from the fertile minds of the original Milan group. We see
"irreverence" as a development of the concept of "curiosity"
which was a development of the concept of "neutrality" before
that.
The family therapy field is also developing, a n d we see
therapists breaking down many of the traditional boundaries
associated with "schools of therapy". The contexts i n which
family work is done seem Increasingly complex as issues s u c h
as child protection, gender, and race, are given greater promi­
nence. Therapists are developing new models that span the
boundaries which seemed inviolate a few years ago. T h i s book
offers the reader a systemic framework from which to challenge
the current ideologies, whether they be in the family or in the
field, or i n the mind of the therapist.
David Campbell
Ros Draper

London
FOREWORD

Bradford P. Keeney

D uring medieval times a holiday took place throughout

Europe called the Feast of Fools. Although not popular
with the nobility and ruling class, it was celebrated
by the locals, who, dressed up as church and court officials,
ridiculed and rendered absurd the most respected ideas, ideals,
rituals, and customs.
An important contribution of the Feast of Fools was to dis­
empower the powerful and empower the local citizenry. As
Harvey Cox (1969, p. 5) notes, "unmasking the pretence of the
powerful always makes the power seem less irresistible", and
this "is why tyrants tremble before fools and dictators ban politi­
cal cabarets".
In this present volume, an odd custom has re-entered our
ranks to celebrate a feast of irreverence. In doing so, everyday
practitioners may be freed from the irresistible grip of profes­
sional schools, journals, books, master therapists, and all the
pomp and regalia of the field.
More than a release from the received and chained views of
pious professionalism, the contribution of Cecchin, Lane, and
ix
X FOREWORD

Ray is an invitation to play and take play seriously to

make serious contributions to the lives of clients. Through the
practice of irreverence, we will sometimes fail to honour, vener­
ate, or even practise the axioms set forth by the various psycho­
theologies. Our work will instead be more organized by
curiosity, desire, passion, imagination, invention, creativity, and
improvization.
The reverent therapist is one committed to revering relevance,
no matter how irreverent his conduct may be in order to achieve
it. This relevance is respectful of "difference" as well as "ab­
sence" in the lives of clients, therapists, and the social institu­
tions embodying them. Stated differently, the "difference that
makes a difference" is as revered as the absence that makes an
"absence". Trying to deconstruct, evaporate, withdraw, or ignore
so-called pathologizing is often as valuable as constructing tan­
gible resources for therapeutic change.
The authors are to be applauded for accepting and rejecting
all totalizing theories and practices of therapies. They show that
every sacred cow in the field is sacred for only a moment, for the
holy therapeutic breath always moves on to embrace the next
contribution in the ever-lasting conversation making up the
history of the profession. Every particular understanding stands
under the subsequent one, although it may differ and sometimes
even seem to negate it. Seen in this more global and ecological
way, the revered "truths" of practice are not solidified com­
mandments in stone, butflexiblebenchmarks, partly relevant
and partly irrelevant. Their "realness" is about as fixed and solid
as a sugar-cube buoy floating on a restless sea.
Readers approaching the buoy thrown out by Cecchin, Lane,
and Ray should take notice of their own responses to it. Does it
evoke freedom, play, imagination, and irreverence? More spe­
cifically, do you find yourself being irreverent to it? If so, the
authors have succeeded in getting you to dance with them.
If not, then I suggest you have taken the book too seriously.
You have approached the book, and perhaps the context of the
whole field in which it is a part, with too much reverence. For
such readers, an intervention maybe suggested:
 FOREWORD Xi

O p e n the book randomly to any page and point your finger to

any sentence or paragraph. Write a counter paragraph stating
w h y y o u believe no one should be irreverent to the subject matter
the sentence(s) address. Then write a letter to the authors thank­
i n g them for inspiring y o u to write the specific counter para­
graph. M a k e certain you say this w i t h finely polished
irreverence, so they can taste their o w n medicine!"

I w e l c o m e a l l c l i n i c i a n s to this feast o f fools. T h e c e l e b r a t i o n

j u g g l e s the e n t i r e f i e l d a n d offers o n e t r a n s f o r m a t i o n after
a n o t h e r o f p r a c t i t i o n e r s ' e t e r n a l verities. T h e o c c a s i o n is o n e o f
d a n c i n g i n the streets a n d t u r n i n g e v e r y t h i n g u p s i d e d o w n a n d
i n s i d e o u t . W h e n the feast is o v e r , w e c a n g o b a c k to o u r jobs
w i t h revitalized reverence for irreverence a n d a further affirma­
tion of being human.
PREFACE

W e come from very different experiences; we are of dif­

ferent ages and backgrounds. For a number of years
each of us has separately been pursuing our work in
systemic family therapy in different parts of the world. After sev­
eral chance meetings at different workshops, wefoundourselves
in an intense, on-going conversation about such topics as
strategizing, cybernetics (first and second order), and narrative
in relation to our practice. From these meetings an organizing
theme emerged that we eventually decided to call irreverence.
Over the course of the subsequent two years we have been meet­
ing regularly in Atlanta, Georgia, for the purpose of elaborating
this idea of irreverence.
In writing this book, it is our hope to offer to the readers a
meta-perspective that holds the potential for lifting some people
out of what we experience as an endless debate about such di­
chotomies as strategizing versus non-intervention, power versus
respect, narrative versus cybernetics, and about which school of
therapy is "more correct". This book is our contribution to this
lively debate. We invite the reader to join our conversation.
xiii
ACKNOWLEDGEMENTS

The authors would like to thank Tom Corbett and Charlie Tauber
of Hillside Hospital, Atlanta, Georgia, for their kind support of
this project.

AUTHORS' NOTE
Although the authors recognize the necessity for awareness of
gender sensitivity, for the sake of simplicity the masculine pro­
noun has in general been used. Also, in the case examples that
are used throughout the book to illustrate the authors' ideas, in
order to maintain the highest level of confidentiality personal
names—and if necessary the context of cases—have been
altered or not presented.

xiv
CHAPTER ONE

The idea of irreverence

Some people are survivors, and others are annihilated by

life's tragedies, and that is just one of the cruelties of living.
Woody Allen

T
his book is an attempt to describe our strategies for sur­
vival in the rough sea of family therapy. When you ven­
ture into these choppy waters, you are bound to meet
many dangers, whether you are a beginner or an expert.
As a beginner, the first problem you meet is to decide which
school to follow. Very soon you could be told that the school you
have chosen is part of your personal problems. Then, when you
begin to work in an institution, such as a psychiatric hospital,
you are told that, "Everything you learned in family therapy
training does not fit here". Searching for a life-line you go to
conferences where you meet gurus who convince you that they
have found the only right way to do therapy. When you try to
interview a couple or a family you either end up looking like
1
2 IRREVERENCE

someone who has been brainwashed by the prevailing patriar­

chal culture, or make others uneasy by your politically correct
feminist leanings.
The most common double-bind you find yourself in is when a
supervisor or teacher tells you that everything you are doing is
wrong, too mechanical; it should be more spontaneously creative
(i.e. just like me). When you try to just talk to a family, the super­
visor accuses you of being too conversational and not taking re­
sponsibility for change. If your behaviour is more directive and
solution-oriented, you are accused of becoming a dictator or
colonizer (Jackson, 1963) who does not respect the family story
enough.
To make things more complicated, there are still some people
who believe family therapy should become a hard science. And
what could be harder? As a therapist who is only doing his best
to help clients, you are told that your lack of success is due to not
havingreadenoughresearchon family process. Usually you are
told something of that sort when your are in the middle of trying
hard to help a client solve a problem, and the last thing you need
to hear is this type of advice, which implies there is something
wrong with you for not being able to handle the family's prob­
lem on your own. Then they give you some sage advice, like,
"Why don't you make a genogram of your own family to find
out what is preventing you from being successful" (like me!).
As an expert therapist, in contrast, you are compelled to repeat
yourself, and, often you become addicted to your model. If you
are a teacher or a supervisor, your colleagues and students may
reinforce this tendency to become stuck, unable to consider other
ways of seeing the world. The people you teach or supervise feed
off and feed your certainty. When you feel you have created
some grand scheme for solving human suffering, you come into
contact with other professionals who are equally certain of the
correctness of their views. You are shocked to discover that they
have no faith in your vision and even belittle what they see as
your naive position.
If you dare to push your ideas beyond the safe boundaries of
the family therapy enclave, you may be astounded by how little
importance family therapy dogma has in the larger socio-politi­
 T H E IDEA O F I R R E V E R E N C E 3

cal world (courts, social welfare institutions, traditional psychi­

atry, etc.). For many years, for example, some of the most presti­
gious and influential leaders in the field of family therapy have
attempted to implement well-thought-out systemic models in
reforming the foster care programs in major cities around the
world. Upon encountering the well-organized structure of such
enormous bureaucracies, they have repeatedly discovered the
limits of their prestige and ability to influence. Most of the time,
the directors of these social welfare programs tell a would-be
reformer that his ideas were theoretically interesting, especially
to the workers at the direct service level. Unfortunately, how­
ever, the would-be reformers remain mystified as to why their
ideas and techniques, which have proved very useful in working
with an individual or with families, are not acceptable within
such a well-established and multifaceted system as a large city
welfare organization.
When, as an expert, you venture into publishing an important
book or paper, some colleagues become loyal to your ideas and
then insist that you stick with those original insights. Any move
away from what people expect from you will be resented, or
even denied. One frequently hears humorous stories about the
profound meaning some people attached to any act of Milton
Erickson during the last years of his life. If he fell asleep, it could
be interpreted as a paradoxical signal for the person in his pres­
ence to relax (whereas it could simply have been that he was
sleepy). The danger of becoming labelled as knowing a "truth"
restricts both the "expert" and those who would learn from "ex­
perts". One of the authors, stuck with the reputation of being a
paradoxical therapist, once forgot his role and, upon meeting a
family, simply asked, "How are you?" One beginning student
who was observing immediately turned to another and com­
mented, "Where's the beef?"
In contrast to the trap where leaders are expected to maintain
a stagnant position of "truth", Murray Bowen seemed to us to
have been caught in an opposite position. Being one of the most
important and influential seminal thinkers in the field, he spent a
great deal of his energy trying to convince others of the scientific
truth of his ideas, often showing frustration and irritation to­
4 IRREVERENCE

wards people who seemed unable or unwilling to understand

his model. Not even the presence of a group of loyal followers
seemed to diminish his annoyance at being misunderstood.
How then, as experts, can we survive between this Scylla and
Charybdis of having people believe you so much that you
become trapped, or of you believing so much in your own
ideas that you spend all your time trying to guard the faith of
your followers? Conversely, as beginners, how can you survive
between the temptation to be a loyal student or becoming hope­
lessly eclectic? Perhaps one answer is to keep attending work­
shops and conferences, which seems to us to be necessary to
sustain the illusion of the importance of family therapy in the
world at large.
We, in some way, would like to recuperate the strengths of
the family therapy movement, which has remained on the fringe
of the culture and of the mental health field. The advantageous
position of being on the fringe is a result of the near blasphemy
of the originators of the family therapy field, who harshly
challenged the prevailing psychiatric dogmas from the 1950s on­
ward. Ironically, in our introducing the idea of irreverence in this
book we consider ourselves to be quite conservative in our desire
to recover this sense of intellectual freedom and integrity handed
down to us by the originators of the field.
How did we arrive at the position of irreverence as an organiz­
ing principle for our survival? For many years each of us was
plagued by doubts when we were learning, teaching therapy,
sitting with a family, discussing with colleagues, and so forth.
We were at war against our doubts, and we always felt we were
losing because after brief victories these doubts would creep in
again. This experience was demoralizing, as long as we consid­
ered it a handicap. Our belief at that time was that a responsible
therapist should know and believe in what he is doing, without
spending half his time brooding over it. Fortunately, after many
years of frustration, we got fed up with it.
As is often the case for us when we reach such a demoralized
state, we find the stories of Gregory Bateson to be helpful. In the
1960s Bateson was living in Hawaii, where he was involved
inresearchon the communicative behaviour of porpoises. He
 T H E IDEA O F I R R E V E R E N C E 5

worked with a group of young researchers who were also inter­

ested in studying the behaviour of dolphins, but who had very
little money to support the research. So, they set up a program:
they would train dolphins to do tricks and invite a public audi­
ence to pay a small admission fee to watch the dolphins perform.
Being highly ethical, the group refused to show the porpoises
repeating the same tricks over and over, because the idea was to
allow the audience to watch the trainer teach them new tricks.
The story goes that one day they were working with a new
dolphin. The trainer held a fish up, the dolphin jumped, and a
fish was given. Later in the day the next audience came, the dol­
phin came around and performed the same trick, and, of course,
the trainer did not reward him with afish,because the idea was
to perform a new trick. Eventually, after repeated failures to
attain a fish because he kept repeating the same behaviour, the
dolphin performed a new trick, a back-flip, and a fish was given
to reward the new behaviour. Unfortunately, when the porpoise
repeated the behaviour, it was not rewarded, even though the
new trick was repeated several times. Right before the sixth per­
formance, the trainers looked over at the holding tank and no­
ticed that this dolphin was making an incredible amount of noise
and splashing: the porpoise had performed six new tricks that
had never before been recorded. Bateson's description of the
situation was that through this long, frustrating process of re­
peating the same behaviour in hopes of getting a reward but
being frustrated, the dolphin finally figured out that this was a
situation in which new behaviour had to be demonstrated in
order to gain a reward. The dolphin had learned how to learn.
Not unlike the dolphin in Bateson's famous story, we experi­
enced a creative leap in learning. After years of frustration, we
began to experience our doubting as a state of irreverence. Doubt
became an asset rather than a hindrance.
In the chapters that follow, the reader will find different exam­
ples of therapeutic behaviour that we call irreverence. Many of
the actions described will sound familiar, belonging to the para­
doxical, strategic, and narrative models. We believe, however,
that by using the word "irreverence" we compel ourselves to
expand our reflections to encompass issues of pragmatics and
6 IRREVERENCE

ethics and even, if we are not too ambitious, to question the con­
dition of being a human in this changing world.
For the past four or five years we have been fascinated by
second-order cybernetics. This theory branched into two distinct
directions. One, the theory of second-order cybernetics, empha­
sized the participation of the observer (therapist) in the system,
as with Maturana and Varela's (1980) idea that it is impossible
to have instructive interaction between living beings. Moreover,
Von Foerster (1981) and Keeney (1982,1983) proposed that rela­
tional reality is co-constructed in a linguistic domain. In addi­
tion, the work of Goldner (1988) and other feminist-oriented
practitioners also challenges the limitations of first-order cyber­
netics in explaining the complexity of gender-related issues.
The second direction was a move completely away from
the cybernetic metaphor, to that of a narrative epistemology.
According to Anderson and Goolishian (1988, 1990), White
(1989), and more recently Hoffman (1990), human beings are im­
mersed in a narrative in which everyone participates, but which
can create problems while simultaneously having the potential
for dissolving them. Goolishian and Anderson advocate main­
taining openness in the therapeutic conversation as a way of in­
creasing the likelihood that multiple realities will emerge. One
could characterize this movement towards non-instrumentality
as a position of, "be careful, because if therapists give the illusion
that they can do something, then the system will buy the illusion
of power". In a sense these authors seem to say that to believe in
power is to become an employee of social control, a dictator of
what the therapist believes to be "healthy" or "normal" function­
ing.
In one sense the recent work of Goolishian and others was
an antidote for those of us who had become overly infatuated
with the concepts of strategizing and intervening. Goolishian,
Hoffman, and Andersen's position on instrumentality was very
important politically within the field. When therapy is based too
much on the instrumentality of how to help people change, it
runs the risk of becoming an instrument of the legal system. We
consistently hear concern being voiced by therapists who fear
that they are being placed in a position of becoming co-opted by
 THE IDEA OF IRREVERENCE 7

the legal system, and therefore fear becoming stigmatized as

social controllers.
An advantage of taking the position advocated by Goolishian
is that one can avoid the trap of making promises to the family,
the courts, and other institutions that one is able to help people
change. We feel that therapists who make promises that they
know how to communicate, or how to control, risk not only be­
coming dangerous to the clients but also being manipulated by
agencies of social control.
Here is when the doubts that we mentioned earlier began
to haunt us. It was in the moment when teachers and students
began to ask questions like: If a client asks for help or a sugges­
tion, why not respond? If a situation (e.g. abuse, violence, sui­
cide) requires an authoritarian intervention, why not intervene?
If someone looks for an "expert", why not offer one to him? If
someone looks for a diagnostic label, why not give it to him as a
solution? In essence, the question became: How can a systemic
therapist recoup some initiative without falling into an already
out-dated model based on the illusion of power and control?
To believe too much in non-instrumentality could result in
one being trapped, restricted, and unable to act. One can become
immobilized by the fear of being too active. Or, one could fall
into the magic belief that changing narrative changes people.
Many therapists are under the illusion that simply changing a
label always solves even chronicfamilydramas. If a therapist
is convinced that by giving up strategizing he can become
effective, then he becomes a believer in the instrument of non­
instrumentality. Often, the temptation to control through non­
instrumentality comes back to haunt those of us who have gone
through this process. Thus, the porpoise jump involves fighting
the temptation ever to become a true believer in any one
approach or theory (Whitaker, 1976).
In attempting to move to a position of irreverence, the ques­
tion that must be asked is: Can this shift be made without falling
back into the position of believing too much in our strategies or
in the absence of strategies? One solution to this quandary is
never to become completely seduced by one model or another.
The irreverent therapist seeks never to feel the necessity to obey a
8 IRREVERENCE

particular theory, the rules of the client, or the referral system—

i.e., the courts or social welfare agencies.
It is important to emphasize that it is useful to have clear in
your mind some ethical deontological principles that are part of a
lively debate today within the therapeutic community. [The term
"deontological" relates to "deontology", defined in Webster's Un­
abridged Dictionary (1983) as "that which is binding and proper",or,
more precisely, to "the theory of duty or moral obligation; ethics" .1
The key premise is that excessive loyalty to a specific idea makes
the individual who embraces it irresponsible in relation to the
moral consequences inherently involved. If some disaster hap­
pens it is not the individual who is responsible, but the idea (with
a capital "I") from which the action springs (such as the position
taken by defendants at the Nuremberg Trials, for example, where
the claim was that they were not responsible for their behaviour
because of excessive loyalty to Third Reich). So, in thefieldof
psychiatry, a total commitment to the idea that mental disease is of
biological origin, or that the problem we face is a result of emo­
tional or environmental deprivation, compels the therapist to be­
come a manager of impossible situations. Then the only "ethical"
solution is to become an "expert" and "takecharge" of the patient's
life.
From our viewpoint, which some may consider extreme, this
position is irresponsible because the therapist who takes this
stance often lacks the capacity to examine the pragmatic conse­
quences of his own behaviour. He is not aware that his way of
acting and thinking has become part of the problem. Irreverence,
as described here, is an attempt to recoup what for us is a more
ethical deontological position.
Somebody could object: "If it is dangerous to believe too
strongly in a theory, then it would also seem useless to study or
conduct research—in therapy, anything goes." We would dis­
agree strongly with this. You have to know something very well
before you are able to be irreverent towards it. You should be
conversant with the literature of different therapeutic perspec­
tives and be an "expert" in at least one of them. This is not to
say that even a beginning therapist cannot, under pressure from
either a supervisor or client, sense that what he is doing is not
 T H E IDEA O F I R R E V E R E N C E 9

working. Much more will be said about this point in chapter

four, on training.
In summary, it is the therapist's enthusiasm for a model or a
hypothesis that can help him to get close to a family, while
simultaneously maintaining a certain level of curiosity and re­
spect. But it is at the moment when the therapist begins to reflect
upon the effect of his own attitude and presumptions that he
acquires a position that is both ethical and therapeutic. In order
to be able to attain this ability for self-reflexivity, we believe that
it is necessary to have a certain level of irreverence and a sense of
humour, which one acquires by maintaining a continuous con­
versation with colleagues, people outside the mental health field,
students, and patients alike.
Irreverence varies greatly from being a revolutionary or from
fighting oppression in the family and/or institution. It is a posi­
tion reflective of a state of mind of the therapist that frees him by
allowing him to take action without falling victim to the illusion
of control. The position of systemic irreverence allows the thera­
pist to juxtapose ideas that might at first look contradictory.
Furthermore, the irreverent therapist constantly undermines
the patterns and stories constraining the family, promoting un­
certainty, and thus allowing the client's system an opportunity to
evolve new beliefs and meanings and less restrictive patterns.
However, in moving towards a position of irreverence, the thera­
pist attempts to remain free from the co-optive nature of consen­
sual belief, to be willing not to become a true believer in what he
is asked to do by the state, or the institution, or even the clinic in
which he works.
A striking example can be seen in the behaviour of Fidel
Castro as he attempts to adapt to the end of the cold war. This
change appears to be having the effect of hardening Castro's be­
lief in his own construction about what is the best form of gov­
ernment for Cuba. Even the slightest form of irreverence to his
beliefs in communist doctrine must seem to him to be immoral. It
appears that he is willing to bring Cuba and himself to the point
of destruction in order to keep faith with the principles he has
been loyal to for thirty years. To be disloyal to any part of his
doctrine seems for Castro to be an unforgivable sin.
10 IRREVERENCE

By becoming irreverent, the individual is free to be playful

without falling into the impoverished meaning system that is
constraining him. He is free to begin to look for the absurd
aspects of the situation, as well as for the tragic.
In our small world of therapy, it is the irreverent therapist's
job to undermine those aspects of the clients' reality that are
restricting them from making the changes they desire. The irrev­
erent therapist is sceptical towards polarities, thereby affording
himself freedom from both the passive position of, "I must not
go in and introduce an idea about how people can change/' and
the strategic position of, "I've got to come up with a tactic". With
irreverence the therapist introduces an idea but does not neces­
sarily believe that people should follow it.
Just as it is impossible not to communicate, it is also impos­
sible not to have a hypothesis. Why should a therapist try to
control a desire to formulate a hypothesis, an idea? Instead, why
not utilize this notion to maximum benefit? As long as he does
not fall in love with the hypothesis, as long as he plays with it, or
talks to colleagues about it, there appears to be no valid argu­
ment to prevent him from building a hypothesis. The therapist
can take responsibility for his feeling or guess, yet be willing to
discard the idea when it is no longer useful. He can use hypo­
theses as descriptions rather than as explanations.
Sometimes the therapist may desire to take a more directive
approach, such as performing a ritual. Why restrict oneself to
being reverent to never doing anything? Why not sometimes
take action? We postulate that it is appropriate to act as long as
the therapist is willing to accept responsibility for his actions,
particularly if he places a time-frame around the action he is
taking. We want to emphasize this point. A therapist can easily
say to a patient that he will consider him a psychiatric patient for
the next two weeks during the patient's hospitalization. He can
choose, temporarily, to control a patient's freedom during the
time he believes the patient to be suicidal. He can take care of the
life of an "incompetent" person for the time he believes that per­
son to be incapable of taking care of himself. And lastly, as a
student, he can choose to believe in a teacher during the two or
four years that his training course lasts.
 THE IDEA OF IRREVERENCE 11

The therapist is not interested in knowing what really pro­

duces change, only in the change that actually occurs. Irrever­
ence is to never accept one logical level of a position but,
rather, to play with varying levels of abstractions, changing from
one level to another. Instead of accepting any fixed descriptions,
irreverence posits eroding certainty. Whenever the client ex­
presses certainty, the irreverent therapist then describes the phe­
nomenon at another level of abstraction. Such a position often
involves doing the exact opposite of what received wisdom
(Weakland, 1989) prescribes. The client came seeking change;
however, the irreverent therapist may tell the client that what he
is doing is good, go slow, don't change.
So, put your life-jacket on and get both oars into the water as
we plunge into an irreverent excursion through the wonderfully
perilous waters of family therapy.
CHAPTER TWO

Irreverence and violence

C ertain topics are so emotionally laden that some people

seem to think that systemic ideas do not apply in such
cases. Certain subjects or presenting problems are so
sensitive that people have great difficulty moving beyond their
own feelings. These problems include many kinds of interper­
sonal violence between genders, and particularly incest. It is
almost as though where there are strong emotions, there is a
strong tendency towards either/or dichotomization of the topic:
black or white, good or bad, victim/victimized. In such instances
individual perspectives become so reactive that it is difficult to
believe that system theory applies, rather that it pertains only to
very nice people. It is as though with certain topics only primi­
tive responses prevail. Incest, child neglect or abuse, and spouse
battering are examples of topics that evoke strong emotional re­
actions that can make effective therapy difficult.
One way of thinking about violence would be to consider the
stories that are available today, in 1992. Victim and perpetrator,
oppressor and oppressed, equal participation, impassioned and

13
14 IRREVERENCE

passionless—these are but a few. Two especially seem currently

to prevail.
One, the feminist position, conceptualizes violence towards
woman as being a product of women being victims of an oppres­
sive male-dominated society. Feminists hold certain strong val­
ues about which they do not wish to be irreverent. For example,
with respect to violence, the feminist position is very much like
the more traditional orientations to violence (i.e. conceptualized
in terms of a victim/victimizer duality). The second, the sys­
temic orientation, moves away from the whole victim/victimizer
dichotomy, choosing to focus more on the patterns of interac­
tion that connect people and that trigger violent patterns of be­
haviour.
The irreverent perspective we are advocating allows the
freedom torespectthe values of both of these orientations with­
out being restricted to absolute adherence to either one. Having
too much faith in any position, any story, we run theriskof
creating an inflexible, impoverished therapeutic reality. That is
the essence of our irreverent position. We are not suggesting that
irreverence is better than any other story. Rather, we pose the
question, how can we train ourselves to be disloyal to any story
when or if it becomes no longer useful?
Without seeming disrespectful to the potential dangers of the
world, we would like to echo a provocative point of view voiced
by Camile Paglia, who makes a strong case in her book Sexual
Persona (1989) that there are situations in which it is too simple
to think that violence towards women is a political problem of
power. Paglia is of the opinion that sex can be a far darker power
for both men and woman than has generally been admitted. Sex
and violence have been part of our human history for cen­
turies—they are nothing new. Society, according to Paglia, was
created by humans to defend us from nature—but nature keeps
seeping in, in millions of ways.
Society is an artificial construction. A defense against nature's

power. Without society, we would be a storm tossed on a barba­

rous sea that is nature. Society is a system of inherent form reduc­

ing our humiliating passivity to nature. We may alter these forms

 IRREVERENCE A N D VIOLENCE 15

slowly or suddenly, but no change in society will ever change

nature, [p. 4]

Even though as therapists we persistently strive to eliminate

these aspects of human behaviour, violence, rape, and incest are
always with us. A s therapists, when we encounter these situa­
tions, we should not be so paralysed. Such events are natural
phenomena, so why be terrified? When we react purely emotion­
ally, it becomes our problem and we are then of little help to our
clients. Paglia does not condone violence; rather, she acknowl­
edges its existence as part of nature. In a post-modern world
where many of the certainties that acted to separate us from
nature, and upon which we have relied so heavily, are now
being questioned, it is essential, according to Paglia, to remem­
ber that we are a part of and are immersed in nature.
Paglia (1989) also challenges the radical feminist notion that
women are the victims of men:

Male bonding and patriarchy were the recourse to which man

was forced by his terrible sense of woman's power, her impervi­
ousness, her archetypal confederacy with chthonian nature.
Woman's body is a labyrinth in which man is lost. It is a walled
garden, a medieval hortus conclusus, in which nature works its
daemonic sorcery. Woman is the primeval fabricator, the real
first mover. She turns a gob of refuse into a spreading web of
sentient being, floating on the snaky umbilical by which she
leashes every man. [p. 12]

A contrast to both the feminist's and Paglia's stories is the

systemic orientation, which, rather than placing primary empha­
sis on the individual, is more concerned with the circular nature
of causality, feedback, pattern, and the relationships between
people. A n y of these theories can be useful in a given situation.
A s therapists we are there to assist, so we should use whatever
stories are contextually appropriate in helping the clients.
As therapists with a particular love for a systemic orientation,
one observation that we have found useful is that in many cases
involving violence, there is a strong undercurrent of sexual pas­
sion—a prevailing theme that we encountered during the course
of working with many court-referred violent families. We be­
16 IRREVERENCE

came interested in the idea that in many instances passion some­

how holds couples together, even though there is severe violence
in the relationship. What we have found is that the so-called
sado-masochistic aspect can be very sexy, very passionate, and
extremely dangerous for many of these couples. We have found
this to be a particularly resourceful story to examine when work­
ing with couples' violence.
In our experience, even though we often observed passion
as an important part of many violent situations, we have been
somewhat reticent about starting to talk about this with other
colleagues in the field, because we feared attack by the feminists
for not recognizing that women are oppressed. Now, one of
the things that seems to disturb some therapists the most about
working with violence is that they cannot stand both the intense
level of physical pain and the sexual passion present within a
couple. Couples involved in violence are often extremely intense
about each other, and frankly many therapists with conventional
middle-class values are afraid to think about violence from a
non-traditional perspective—for example, as being a matter of
passion that leads to a violent dance in which two adults are
involved—let alone actually to do anything controversial when
working with violence.
In many instances, couples involved in violence are willing to
die for those relationships, willing to die for the passion, willing
to risk their lives. Some therapists have difficulty understanding
this since they, themselves, would rather divorce—just pay the
legal fees and go. This seems to us to be a commonly held west­
ern cultural pattern.
Recognizing that a therapist can be organized by any one of a
number of different stories, the question then becomes, what do
you do? Every therapist, of course, chooses one story or another.
It is impossible not to choose. If you are a feminist, you are or­
ganized by the feminist bias. If you are a cyberneticaily oriented
therapist you are organized by a systemic bias—Bowen, MRI,
solution-focused, Milan, etc The therapist chooses the one he
feels most comfortable with. In contrast, the irreverent therapist
is willing to abandon his prejudice if he is stuck, and to choose
another that betterfitsthe clinical situation. Our point is that
 IRREVERENCE A N D VIOLENCE 17

therapists should strive to be aware of the consequences of

the choices they make. This is the responsible position therapeu­
tically.

The homicidal lady and the polite therapist

A violent couple came for treatment after the husband had, on

two occasions, been physically violent with the wife. The wife
had responded by fighting back, attacking him as well. Based on
the interviews, the therapist was convinced that the man was
involved in a gay relationship with another man. The therapist
was worried that the husband would spread AIDS to the wife.
She was a victim. The therapist felt very protective towards this
wife and formed a very strong attachment to her. He attempted
to separate the couple, suggesting that the woman leave her hus­
band and go to a shelter for battered women. The therapist took a
traditional victim/victimizer position, insisting that the husband
was an oppressor who was victimizing his wife.
One of the authors was called in as a consultant in the after­
math of the case: the woman had murdered her husband after an
argument during which the husband had announced he was
leaving to go to live with his gay lover. At the time of the consul­
tation, even though the woman had killed the husband, the
therapist still continued to view the woman as the victim of the
man.
What can be learnedfroma tragic case like this? It looked as
though the therapist, by taking an inflexible victim/victimizer
position, was unable to help the couple to disengage from
their deadly dance. He was so reverent to the idea of victim and
oppressor that through his inability to help the couple generate
alternative premises and patterns he participated in creating a
context in which the wife killed her husband. By being so loyal to
the ideas of victim /victimizer, the therapist helped to set up a
therapeutic context in which there was no possibility for change.
One could say that the process of joining with the wife by con­
tinually emphasizing that the husband was oppressing her,
contributed to the wife developing an inability to see any option
other than murder.
18 IRREVERENCE

One really sad aspect of this story is that some people—

including many therapists—would say, "See, we knew this was
going to lead to violence". If the therapist continues to maintain
that in situations in which men oppress women such things hap­
pen, he can then walk away feeling validated about the serious­
ness of the situation, voicing such justifications as: "I knew all
along that this was a very dangerous situation. If I could only
have gotten the man to stop oppressing her, she wouldn't have
been pushed to the point of killing him." And the therapist
would never even recognize that he had participated in some
way in setting the scenario such that deadly violence would
occur.
The supervisor in this case was also partially responsible, in
that he was unable to convince the therapist to loosen up. The
supervisor tried to discourage the therapist's hard-line oppres­
sor/oppressed position, but became so annoyed about this
inflexible feminist position that he took the opposite pole and
became fanatically anti-feminist. Becoming too rigidly anti-femi­
nist, the supervisor enflamed the therapist's feminist orientation.
As long as the supervisor rejected the therapists' position that the
husband was oppressing the wife, the therapist could not hear
the supervisor. The supervisor was not able to talk effectively to
the therapist who, in turn, was not able to see the situation differ­
ently—and so the tragedy happened. Why was the supervisor
unable to convince the therapist? Because he was so fanatical
about his own idea that he created a symmetrical escalation from
which neither of them could escape.
The therapist had a terrible emotional reaction to the tragedy.
Later, but too late, he started to think about the implications of
holding on adamantly to an oppressor/victim framework. When
you think about therapeutic responsibility, consider the potential
danger of believing too strongly in your paradigm. What is the
point?
 IRREVERENCE AND VIOLENCE 19

The passionless couple

In another instance, a case referred through the courts involved a
man who was a pianist in a jazz band. He and his wife came
to therapy because his wife had beaten him up. She was very
violent with him, pushing him around because he drank and
watched television all the time. The daughters aligned with the
mother, and they all criticized him for the drinking, for watching
too much television, for not doing enough work around the
house. Eventually what happened through the therapeutic con­
versation over time is that the wife—an executive with a very
good job—got so fed up with him that she kicked him out. He got
his own place and ended up surviving, and the family also sur­
vived. He still had a poor relationship with his children after that.
It was a very simple story, with no magic solution, but it dem­
onstrates a slightly different slant on couples' violence. The
woman was not oppressing the man, but bullying him and beat­
ing him up. The wife realized that the husband was not going to
change. He was not going to become involved with her, he was
not going to become more responsible around the house. The
husband became more aware that he really was not interested in
this family. He was much more interested in television and mu­
sic, and he preferred being alone. So, through the therapeutic
conversation, they realized that there was really no reason to stay
together.
The wife took the initiative to ask him to leave, and the
violence stopped. She had been so frustrated with him that she
would attack him and start hitting him, punching him. He
would then call the police. What therapy did was help each of
them decide that what they were doing together was not useful.
They were not having their needs met.
How does this example reflect an irreverent position? With
this family, the therapist was working on the basis of the hypo­
thesis that violence always involves passion, that violence is a
sign of passion. For months the therapist tried to bring out the
passion, the bond, but then it just was not helpful. The couple
kept repeating themselves. Nothing changed. Then the therapist
happened to wake up one morning with the idea that he had to
20 IRREVERENCE

be disloyaltohis hypothesis and adopt a different one because

they couple just did not like each other. The therapistfinallyhad
to say, "Hey, there is no passion here". With the other couples he
was working with, the passion that connected them was clear,
but this one did not make sense.
For us, the interesting aspect of this case was the therapist's
initial conviction that where there is violence there is always
passion. In therapy, the story shifted to talking so much about
passion that the couple realized that there was no passion re­
maining between them. Searching for the passion was helpful;
but then the therapist came to the realization that he had to be
disloyal to his idea that such couples are always very passionate.
He was then free to ask himself if there was another possibility.
Interestingly enough, once the therapist had come to this conclu­
sion he discovered during the next session that both spouses
were having similar ideas. In therapy they began to talk about,
"Why don't you just end this? Why not just leave?" Was the
therapist the one to suggest that the passion was gone, or was it
the clients? Who knows.
By talking about passion, they became aware that they did not
have any. The couple finally got so fed up with coming and try­
ing to find how to shift the passion of violence to more affection
and love that they decided they did not really want to be to­
gether. But they were only able to do this after the therapist had
awoken to the idea that his passion for the passion theory was no
longer useful. His irreverence to his own idea was helpful to the
couple in deciding to separate.
How was the therapist able to abandon a theory that had
previously been useful in working with so many couples with
violence? He became totally frustrated and said to himself, "I
can't figure out why you continue to stay together. I cannot find
the connection, the passion here. All Ifindis frustration, hatred."
The therapist's irreverence to his own conceptualization of
the situation as being passion became the healthy moment of
the therapy. His ability to question his own way of looking at the
situation helped the couple to make a move. The therapy became
unstuck the moment the therapist began to have doubts about
 IRREVERENCE A N D VIOLENCE 21

his own theory. When one is able to doubt one's own theory, the
client is given permission to move.
To reiterate, a key for accessing irreverence is for the therapist
to have the courage to recognize the source of his frustration and
take action in questioning his own theory about the situation,
instead of being protective of himself. That is the art of becoming
irreverent. One could say that when the therapist starts getting
frustrated, it is a symptom or a sign that he may have become too
reverent to his own story. Which means also that one should not
be afraid to be irreverent. A part of being irreverent, is to have the
courage to not fight for an idea that is no longer useful or congru­
ent to the context at hand. This is a healthy thing you can do for
your sanity, as well as for the client.

The nowhere man

A colleague came for a consultation, bringing a story about a

patient that was very upsetting for him. He had been working
with a 40-year-old chronic patient who had been a heavy utilizer
of psychiatric and social services, going to the out-patient clinic
for medication, and otherwise living a life of isolation from
others. The therapist became very fascinated by the patient and
set out to help him become a more socially active person. He
devised a programme of treatment for the patient. In a very gentle
manner, he organized group interactions for him and helped him
get into an apartment for mental patients, where he could work
with other people in learning basic living skills such as cooking
and so forth. The patient struggled with these changes at first
but seemed eager to please the therapist, and he followed the
programme of treatment. To the therapist the patient seemed to
improve. He was gradually becoming more social with other
people in the apartment complex, participating more actively in
group activities, and was even at the point of attaining a job.
Just when it appeared that the patient was making noticeable
improvement, the therapist received news that the patient had
hung himself during a trip to a distant city to visit his family.
The therapist was shocked. He could not understand what
22 IRREVERENCE

had happened. In the supervision group discussion a hypothesis

emerged, which posited, "Is it possible that, faced with the
challenge of finding a job and more intense involvement
with other people, the patient had an experience of lower self­
esteem because of an increased awareness of his inability to
really get touch with other people?" Did the therapist's efforts to
help him have the opposite effect, that of pushing him towards
suicide?
From our point of view, the patient was not able to be irrever­
ent to the therapist's attempts to help him, and the therapist was
unable to be disloyal to the theory that human beings are more
healthy if they socialize. It is also possible that the patient was
unable to be irreverent to his family's need for him to have prob­
lems. He may have preferred to kill himself—and be institution­
alized, through death, as unsuccessful—rather than risk
improvement. The therapist, however, was a traditionally
trained psychiatrist whose training did not involve considera­
tion of the family situation.

The therapist who became the father

Another case involved multiple suicide attempts on the part

of an 18-year-old daughter and later by her mother. Therapy
seemed to be progressing well when the therapist realized he
had been seeing the family for over six months—which is an
unusually long period of treatment in this work setting. What
finally dawned on the therapist was that the therapy was stuck
because he kept trying to do the same thing with the husband
and wife that they, as parents, were attempting to do with their
daughter. The therapist was attempting to make them change
how they were behaving with one another. In a way he was
attempting to coerce them to change, and in so doing was insti­
gating the very behaviour he was trying to help them change. It
was the therapist's addiction to his idea about how the couple
should act and his subsequent stubborn demand that they con­
form to his viewpoint, and not that of the family, that was keep­
ing things stuck. Having finally realized that he was paralleling
the same process that the parents were doing with their daugh­
 IRREVERENCE A N D VIOLENCE 23

ter, he pulled back, changing his own conceptual frame and how
he was behaving towards the family. Immediately the tension
broke between the husband and wife. The father was able to
loosen up in his demands towards the daughter to grow up
according to his plan. The mother and father began renegotiating
their relationship, beginning to adjust to life with one another
after the children had left the home. It was only after the thera­
pist was able to challenge his own beliefs about what was wrong
with the family, after he began to act differently towards them,
that the family began to improve.
What, then, is irreverent about this case? The irreverence
occurred when the therapist realized that his conceptualization
and attempt to control the parents' style of parenting was similar
to the way in which the father was trying to control the daughter
and wife. This realization came to the therapist like a slap in the
face. Therapy started progressing only after the therapist became
irreverent to his own hypothesis.

Punishment as treatment
In a consultation group a female therapist described a case from
a sex-offenders group she was leading. The group was made up
of men who had sexually abused children. Many of the men had
served time in prison for this crime. Some had been given
the option to attend the group in order to avoid longer prison
sentences; for others, involvement in the group was a condition
of parole. This particular group had been on-going for several
years.
The dilemma that the therapist brought to the group was that
a man who had been a loyal member of the group for some time,
one who, the therapist believed, had stopped any type of sexual
abuse, was arrested, accused of molesting his 3Vi-year-old grand­
daughter. The therapist was shocked and angry about the recur­
rence of sexual abuse, appearing to view it as a personal affront.
The therapist related that over the course of treatment she
was certain that the man had made progress, and she could not
fathom the idea that he would go back to this behaviour. She was
angry at him andfelthe deserved to be punished for the crime.
24 IRREVERENCE

She also noticed that the other men in the group were very
anxious about the revelation, since members had great difficulty
even admitting that they had sexual desires for children.
The therapist conveyed that her original contract with the
group members was that if they were involved again in any child
molestation, they would not be allowed to continue in the group.
However, the man was denying the accusation that he had sexu­
ally abused his granddaughter, even though his daughter-in-law
(the child's mother) had taken the child to the police and re­
ported the story.
From a family perspective, the daughter-in-law had also ac­
cused the man of raping her several years earlier. He had also
denied that charge and, subsequently, no action had been taken
by the police. Interestingly enough, the daughter-in-law had sent
her 3Vi-year-old child to spend the night with the grandparents.
The child had slept in the bed with both grandparents, and it was
during this time that she was allegedly molested by the grand­
father.
The consultation group was struck by the possibility that the
daughter-in-law may have sent her daughter to spend the night
at the grandparents' house in order to set up her father-in-law, as
an act of revenge for her past rape. As stated above, he denied all
accusations.
The therapist was stuck as to how this information should be
used in the sexual-offenders group. One suggestion was that she
could tell the man in front of the group that over the course of the
preceding year and a half he had convinced her that she had
cured him of his paedophile tendencies. Another idea involved
the fact that the men in the sexual-offenders group always de­
nied that they experienced these paedophile feelings. This man
had allegedly acted on some feeling that could result in a long
prison term. He had carelessly allowed himself to sleep in the
same bed with his granddaughter. We recommended that the
therapist state to the group that sexual impulses are extremely
powerful; one can be lulled into thinking that this behaviour
is under control, and then a tragedy like this can take place. It
is unfortunate that the man has to face the consequences of
this accusation; however, for the group it is a helpful reminder to
 IRREVERENCE A N D VIOLENCE 25

everyone of the danger involved in allowing themselves to be

placed in such vulnerable situations.
In the consultation group the question arose as to whether
kicking the man out of the treatment group would be helpful
to the group as a whole. If he was allowed to remain, would
it damage the contract and premise held within the group that
members could remain only as long as they did not sexually
abuse children? The solution to this dilemma suggested by the
consultation group was for the man to be temporarily suspended
from the group during the investigation and possible trial. If
found innocent of the charges, he could return.
It appeared to the consultant that over time the therapist had
become a true believer in the power of this sexual-molestation
group process to cure paedophilic behaviour. This experience
challenged the therapist's certainty about the absolute curative
value of the group process. Later the therapist expressed that she
felt relieved of a burden of responsibility she had been carrying
for preventing future sexual misbehaviour by the group mem­
bers. The therapist was able to become more flexible, better able
to have a meaningful therapeutic relationship with the group
members, by being able to facilitate a more open conversation
about the very forbidden topics for which they were there to
begin with. She felt she would be able to use this ability to
acknowledge doubt to the treatment group about the power of
the group process to cure the desires to have sexual relations
with children. The group members could, however, support one
another and provide a context in which they could safely discuss
these taboo desires, providing a context in which they could ex­
press their fears and concerns.
With the idea of irreverence we emphasize the importance of
therapeutic responsibility. What kind of story do you, as a thera­
pist, prefer? When you prefer one story, are you able, if you see
problems coming up, to be disloyal to your own stories when
they are no longer useful? Can you dare to consider being irrev­
erent to what you "know" is "the" correct way of thinking, at
times when it is not useful? Any story—any of the current ways
of thinking about a given situation—if you are too loyal to it, can
create problems. This is an essential aspect of the final example.
26 IRREVERENCE

A midsummer night's dream

Another example of work with violence involved a couple.
The man was very violent, with a history of beating the woman
frequently and severely . Her two teenage daughters from a pre­
vious marriage could not tolerate this man andrefusedto accept
him as part of the family. They kept complaining to the mother,
"Why do you keep him?", while at the same time they were mis­
behaving to such an extent that therapy was recommended by
the school.
An important issue that came up at the beginning of therapy
was that the mother insisted that her boyfriend behave like a
father to her daughters, but the daughters continued to see him
merely as an unworthy mate of their mother. The girls were furi­
ous at any attempt of the man to be a father to them. They did not
want to come to therapy. The mother, in contrast, wanted to, in
the hope that it would help her daughters accept her man and
that by this acceptance he would beat her less.
After the second session the daughters became annoyed and
dropped out of therapy. A hypothesis was made that as the man
liked to come to therapy and that since therapy had begun his
behaviour had improved slightly, the danger for the daughters
was that he was becoming more acceptable to their mother, who,
they feared, would become even morereluctantto kick him out.
Therapy continued with the couple alone. The man described
how he was furious with his girlfriend much of the time, com­
plaining of her coldness and distance. He said he did not want to
beat her, but she provoked him with her aloofness. When the
conversation turned to his family of origin, a complex story
emerged,relatedto his psychotic sister, who was still living with
their violent father. The man described his father as being a bril­
liant man who controlled his family with an iron fist.
The man felt his family did not understand him and he was
furious about it. He perceived himself to be in a weak position,
which triggered angry outbursts. When he tried to explain him­
self, he felt no one would listen. In this new relationship he saw
himself as being in a position that was very similar to the one he
 IRREVERENCE AND VIOLENCE 27

had in his father's family, one where no one ever took him seri­
ously.
After several therapeutic conversations, some remarks seemed
to have a particular effect on him. It was when the therapist asked,
"Why do you take her so seriously? Everything she does, you
think she's thinking about you? You think everything she does is
a message to you. Why do you have this crazy idea? Perhaps
she is thinking about somebody else, her mother, her sister, her
daughter. She cannot be thinking only about you all the time. You
keep saying that you are not important. So why should she think
of you all of the time?"
The man came back to the next session, saying that that idea
had had a great effect on him, and he felt he was less angry.
The fact that he began to see his woman as someone who is not
always trying to give a message to him was a great relief for him.
He also mentioned some improvement in his relationship with
his family of origin. The woman kept silent throughout most of
this conversation.
At the next session the woman began the conversation in a
very decisive tone, saying to the therapist before he had a chance
to talk: "First this man was beating me up all the time and I had
to take it. I couldn't get out because it was like an addiction. I
wanted to get out, but I couldn't. Then I came into therapy, and
the therapy has been good for him,right?And I have to come
here to get all these insults during these meetings. I have to sit
here and listen to all this bullshit conversation just for him to feel
good. First I was abused because he had to take all the problems
he has with his mother and father out on me by beating me.
Then, he uses me to get therapy so he can feel better. He needed
therapy to get better and he is doing fine, but what about me?
What do I get out of this?"
The therapist naively commented that her boyfriend had
stopped beating her. To which she responded "I don't believe in
this systemic therapy, where people are seen as co-responsible
for his violence—He is responsible! He is the only one respon­
sible! You should punish him, not me! I'm furious that I decided
to come to therapy and he is the one who is getting better. I am
28 IRREVERENCE

being punished, and he should have been punished for beating

me! I'm mad! I'm mad at you!"
The woman's anger and request for punishment for her boy­
friend took the therapist by surprise and upset him. The therapist
said, "I have to think about this. What you are saying is a
shock to me". The therapist left the room to talk with the team.
The team felt that they had misunderstood the woman's initial
request in therapy and that the hypothesis that the beating was
part of a communication did not fit.
The therapist rejoined the couple with no specific idea about
what to do. The woman continued her complaint: "We are still
together, but I feel damaged. Also, now that the violence has
stopped, I find him boring and superficial, and yet I feel com­
pelled to stay with this goddamned, pig, bastard. I want him
punished. You helped him feel better without punishing him,
and I am furious. Two men here getting together, he's getting
better and he doesn't even get any punishment. He got away
with it. So what do you do now? I don't like it!"
The therapist ended the session with these words: "Look,
you're perfectly right. It will take me time to think because I have
this orientation in my head that says that not beating is better
than beating, and that punishing is not helpful. Now you tell me
that to get away with crime without punishment is not a solu­
tion. I don't know what to do. I should do something, but it is
going to take me time to think about this. We will discuss it fur­
ther at the next session."
At the next session he started talking about punishment. What
kind of punishment does she think he should be given? How
long should the punishment last? Weeks? Months? Years? A life
time? "It looks like your daughters are doing a lot of punishing
now by mistreating him!"
At this moment in therapy the therapist had changed the con­
versation from content (the punishment) to the process (the need
to punish in order to maintain the relationship). But in his heart
the therapist did not change his position from thinking that
to cooperate and be gentle with each other was still a better
solution.
In ending the session, the therapist stated: "I will not see you
for six months because of an illness. My sickness is that I think
 IRREVERENCE A N D VIOLENCE 29

cooperation is better thanfighting;thafs my prejudice. So we

should keep away from each other for a while. You go on mis­
treating him. For me, the fact that there is no physical violence is
already progress. But you have demonstrated to me that revenge
is what is important in life. I need time to cure myself of my
prejudice."
The clients came back six months later looking better. The
woman was a little angry and was talking more during the
session. She began by saying, "I'm doing okay since I've asked
my boyfriend to leave home". (Since he moved out, they were
visiting each other two to three times a week.) The man sat
quietly and was very polite. They then told a story about a visit
they had made to their relatives in a small village in Italy. They
described numerous stories about aunts and uncles spending an
inordinate amount of time conniving intricate plots for reveng­
ing new and past slights and wrong-doings.
This was Ruminating for the therapist. He realized that he
had not taken into account the larger culture. He realized that
his prejudice made it impossible for him to see that revenge and
vindictiveness is an important part of some cultures. What the
therapist discovered was that he was not talking the language of
the culture. The therapist was part of a therapeutic culture that
places greater value on cooperation than on war. He told the
couple about his discovery, describing with much emotion this
new insight, speaking without interruption for more than ten
minutes. Finally the couple gave in and began to laugh at
the absurdity of the therapist's rambling, saying, "O.K., O.K.,
lef s forget about this for now" and asked permission to leave
early. As they were going out, the wife, in a playful way,
said: "We will call you in a few months to see how you are
doing."
Six months later the couple telephoned and asked for another
session. When they came in, they appeared healthy and well
groomed. The man had lost some weight, and the wife appeared
to be four or five months pregnant. They looked like a couple
waking up from a long midsummer night's dream. They said
they were back together, and that her daughters had decided to
stay with them and were looking forward to the birth of the new
30 IRREVERENCE

baby. Most of the relatives on both sides were pleased about the
union and the pregnancy. The therapist did not dare to ask them
to explain the obvious transformation in their relationship. We,
too, like Paglia, believe that it is important to remain respectful
towards the mystery of male-female bonding.
CHAPTER THREE

Irreverence in institutions:
survival

"You're a danger. Thaf s why we kill you. I have nothing

against you, you understand, as a man."
Graham Greene, The Power and the Glory

P
sychiatric hospitals, which try very hard to be helpful in
many ways, sometimes inadvertently become only in­
struments of social control, often in spite of the efforts of
therapists working there. By introducing irreverence in the psy­
chiatric hospital, the therapist can help maintain a certain level of
flexibility within a context that does, at times, require social con­
trol. In an institutional setting the therapist is called upon to obey
many contradictory messages—from the clients or the adminis­
tration, or from socio-political, cultural, or legal factions, and so
forth. H e cannot obey everyone, for to do so would mean run­
ning the risk of losing his efficiency and, perhaps, his "sanity".
The position of the irreverent therapist varies from that of a
revolutionary, since the therapist's is not a quest to overcome
oppression. The system that the therapist confronts is double­

31
32 IRREVERENCE

binding, not oppressing. The majority of psychiatric hospitals—

as also the majority of other institutions, such as the church,
welfare, schools, and so forth—usually support stability and pro­
mote dominant cultural values. Thus, accusations are useless.
One does not normally ask the institution to change—rather, one
attempts to survive within the system. Not by obeying, but by
using his own creativity andflexibilityto construct a workable
meaning system, the therapist can utilize this position of irrever­
ence to help institutions become more flexible and less oppres­
sive, even, perhaps, to dissolve completely. As an analogy, one
could say that irreverence on the part of the people and leaders of
the former Soviet Union made a superpower dissolve.
The longer a person survives as a therapist, the more he helps
his clients to find solutions for themselves. His irreverence as a
therapist can be transmitted to the client. The irreverent therapist
doubts that any theory or model has or will capture the "true"
essence of human behaviour, always reserving the flexibility to
challenge the limitations inherent in descriptions imposed by the
institution, the client, and, most importantly, by his own biases.
You have to realize that there are some cases where you will
not be able to help your client in an institution because to do so
may threaten the stability of the institution. There are other in­
stances where patients have chosen—or have been elected into
by the family or community of which they are part—a career
of mental patienthood. These "professional" patients refuse to
change, or they may be in a position that makes it impossible
for them to change, and they are unable to leave the institution.
Sometimes as a therapist you are caught in conflicting loyalties
between the institution and the client, and your solution then is
to give up in order to survive. Of course you can choose to risk
your survival, for example to lose your job, which may at times
be the only ethical alternative. However, most of the time the
therapist must survive if he is going to be helpful to anyone.
All of us can remember a case where we know we could have
done more, but we did not because we could not find the correct
level of irreverence that would allow us to take action and sur­
vive. In an aeroplane, for example, when in an emergency the
oxygen masks come down, you are told to put the mask on your­
 I R R E V E R E N C E IN INSTITUTIONS 33

self first and then to take care of your child—which is to say, you
must survive first, before you can help your child. In institutions
therapists must deal with hard-edged situations. The belief that
we can help everyone is romantic and naive.
As therapists, however, we do not like to be put in a position
of impotence. W e are always looking for the opportunities to be
loyal both to the institution and to the client. This is where the
position of irreverence can be very helpful. Irreverence becomes
a healthy alternative. This is what children have to d o when a
mother wants them to do one thing while the father wants them
to do something else. If the child is able to be slightly irreverent
to both parents, then he is able to keep his job a? ^ child and be
free.
H o w d o you remain flexible in institutions? One way is to
maintain an open dialogue with colleagues and clients aimed at
understanding and respecting the viewpoint of each. O f course,
it is important to remember that the dangers are always the same:
the danger of excessive obedience to one side over the other; or,
to become wildly irreverent and end up looking insane to both
the patient and the institution. This situation reminds us of the
teacher in the film, Dead Poets' Society, who, in his effort to ex­
pand the experience of his students, ended up being scapegoated
by his administrative superiors and his students alike.
O n the one hand, if you become totally obedient to the institu­
tion, you risk appearing like a bureaucratic robot. If, on the other
hand, you become totally dedicated and obedient to the client,
you may appear to be a revolutionary in the eyes of the institu­
tion. In the following case the therapist had to walk a fine line
between helping the client while simultaneously not offending
the institution. H e decided to take the risk of making an interven­
tion that might be deemed appropriate in an out-patient family
therapy setting, but difficult to accept in an institutional setting.

The faeces-eating boy

A 14-year-old boy with an IQ of 60 was incarcerated in a

state school for numerous delinquent acts, including stealing,
drug sale and use, and homosexual prostitution. After a difficult
34 IRREVERENCE

adjustment to institutionalization, the boy began smearing his

own faeces all over his body and in his hair, and rolling the
faeces up into little balls and eating it. At different times, the staff
conceptualized and attempted to work with the boy, first from a
psychodynamic, later a behavioural modification, and finally a
family-of-origin orientation with no success. The staff could not
decide if his behaviour was related more to his retardation or to a
psychotic process. Not knowing what to do with him, they were
planning to "warehouse" him in a state psychiatric hospital
nearby. The therapist, a student of one of the authors, had be­
come very attached to the boy and could not bear to give up
on him. She persuaded the administrators to consult with the
author. The administrator accepted, in a final attempt to con­
vince the therapist that nothing could be done to help the boy.
The consultant posed a very simple question to the therapist,
borrowed from the Brief Therapists at the Mental Research Insti­
tution: "In what context would it make perfect sense for this boy
to begin eating/smearing his own faeces?" Further inquiry to the
therapist revealed that the boy, who was small in stature, was
being raped orally and anally by other boys in the correctional
school. After he began eating faeces and smearing it on himself,
the other boys became repulsed and began avoiding him, calling
him crazy. The faeces eating seemed to protect him from being
raped.
The question now was, how do you intervene in the situation
to help the boy, protect him from assault, and not embarrass the
staff of the institution by suggesting that the other therapeutic
models were failures? The intervention was twofold. First, the
therapist was told to compliment the boy for finding a brilliant
way to protect himself when the institution had been unable to
do so. He was asked to keep smearing faeces on himself, but
to stop eating it because he might get worms. Within a week
the boy had stopped eating his faeces, was clean, and was well
groomed. The therapist worried that the boy was moving too fast
and feared he would be molested again. The boy, however, said
the other kids now left him alone because they all still think he is
crazy. His crazy reputation in place, the boy could now survive
in the institution.
 IRREVERENCE IN INSTITUTIONS 35

What was irreverent in this instance? One point is timing. The

administration was completely frustrated with the situation. Too
much staff time was being spent on the treatment of this one
child. They were able to be irreverent to their own ability to
handle the situation following standard procedures. They were
willing, at this point, to listen to a student therapist who offered a
suggestion proposed by her teacher, who practised from a model
not practised in the institution. The timing was right for an irrev­
erent intervention that would never be allowed at another mo­
ment. The consultant, exercising irreverence, was also aware that
he might never be invited back to this traditional setting to con­
sult again, even though the intervention was successful. Irrever­
ence was an excellent pain killer for the disappointment of losing
a potential consulting job.

How to become a famous

"but not rich" psychiatric patient without even trying
Here we describe an unusual situation observed in a psychiatric
hospital in Scandinavia where, as we heard the story, a man was
hospitalized after threatening to blow up his house while his
wife and children were in it. He was then involuntarily commit­
ted to a state psychiatric hospital.
A powerful and well-respected psychiatrist, known for his re­
search on the paranoid syndrome, took charge of the treatment.
His assessment of the patient was that he represented an un­
usual and rarefied example of lucid paranoia. The psycldatrist
designed a treatment plan based on this assessment and diag­
nosis, and subsequently wrote several papers related to the
progress of the patient.
Disagreeing completely with the diagnosis, the hospitalized
man began a long, entrenched battle with the psychiatrist, the
hospital, and other professionals at the hospital to force them to
change their label. To the psychiatrist and hospital, the harder
the man fought against the diagnosis, the more certain they be­
came of its validity. Utterly refusing to accept the diagnosis, the
36 IRREVERENCE

patient naturally refused to accept any kind of medication or in­

patient psychotherapy.
After several months of deadlocked attempts to engage him
in treatment the psychiatrist prescribed discharge and an out­
patient aftercare program. Continuing to refuse to accept the
diagnosis, the patient refused to leave until it was changed. He
also initiated a law suit against the psychiatrist and the hospital.
Thus, a symmetrical escalation began in which the man and the
institution were caught in a hopeless stalemate. Neither party
could alter its position. It seems to us that the psychiatrist and
hospital could not admit a mistake without becoming liable for
personal damages as a result of confining him involuntarily. The
patient could not accept the diagnosis because to do so would be
to deny his legitimate fury against his family. He pitched a tent
in the grounds in front of the institution, refusing to leave until
his diagnosis was changed.
The case continued to gain notoriety, to the point that when
winter came the hospital was compelled for humanitarian rea­
sons to invite the patient back inside the hospital. So the patient
took on a permanent place of residence in the lobby of the insti­
tution, where, to our knowledge, he continues to live in protest.
Even though the hospital still allows the man to reside there
and the man continues to refuse to agree with the diagnosis, to
us it appears that this battle has faded away. In our opinion the
hospital became irreverent to its own position by discontinuing
its insistence that he leave, thus allowing him to become almost
like a part of the hospital staff and to maintain residence there.
The man became irreverent by changing his perception of the
institution as a persecutor, accepting it as a nice place to live.
Like Bateson's porpoises, both the institution and the patient
were able to make a creative leap out of their dilemma.

The catatonic girl

One of the authors was asked to consult on a case involving
a catatonic 19-year-old girl in a mental hospital. She had been
in this emergency psychiatric hospital for eight months; usually
they keep patients for two to four weeks, then send them either
 IRREVERENCE IN INSTITUTIONS 37

for long-term hospitalization or for out-patient care. In this case,

the hospital staff could not rid get of her because every time
she was ready to leave she created a crisis, becoming catatonic,
would not eat, and had to be fed through a tube.
The parents would come every day, pleading for a solution to
their daughter's problems. The case had become famous in the
community. The psychiatrist in charge of the case was a student
of one of the authors and invited him to do a consultation in­
terview. The father, mother, sister, and brother were invited to
come to the session. The interview was conducted in a room
with a one-way mirror, with the hospital personnel observing.
Sonya, the patient, arrived in a wheel chair pushed by a nurse.
The nurse, who was constantly attending the girl, was invited to
participate in the session. The girl kept her eyes closed but cried
continuously. The mother looked sad and also kept her eyes
closed. The father appeared desperate for help for his daughter.
The older brother and younger sister looked scared and help­
less.
The consultant was perplexed about what to do. The weight of
the burden of the girl's problem was now transferred to the
therapist, who began to feel overwhelmed and desperate. It
seemed as though everyone in the room and behind the mirror
was waiting for a magic bullet to dissolve the girl's symptoms.
At this point the consultant decided to become irreverent to
these impossible demands for a miracle and began to ask, in a
mechanical manner, Milan-style questions to the mother, father,
sister, brother, and Sonya even though she refused to answer.
The questions were the classic ones: How was the relationship
between parents and children?; How did Sonya decide to be­
come catatonic?; Who was most upset?; and so on.
Slowly a story emerged. Sonya had run awayfromhome a
few times when she was younger. At age 16 she disappeared for
several weeks to follow a religious cult, and then she came back.
When she returned she was different, and was totally secretive
about her experiences. The parents felt she had been raped, or
that something similarly terrible had happened to her. Shortly
after this the mother and father began to interrogate her about
her experiences during her disappearance. The more they inter­
38 IRREVERENCE

rogated her the more withdrawn and silent she became, eventu­
ally becoming completely catatonic. The father was very fond of
her, interpreting her silence and withdrawal as a personal rejec­
tion, from which he still felt great pain.
During this crisis in the family, the older brother was prepar­
ing to get married. The mother was totally preoccupied with
planning the wedding. She made it clear that her son's marriage
would represent a major loss for her.
The consultant came out of the interview to talk with the team.
The dilemma for the consultant was how to formulate a way of
using this information in this particular context, in hospital with
a dying girl. The team behind the mirror was made up of psy­
chiatrists and psychiatric nurses who were having great doubts
that this kind of talk therapy was of any value. He decided to go
against the heavy layer of medical pessimism about the patient's
prognosis, electing to make a classical Milan intervention, even
though he felt it was totally incongruent with the context.
The consultant returned to the session, inviting the attending
psychiatrist to accompany him. Looking at the psychiatrist and
nurse, he said, "You have been treating this girl wrong. This girl
has been here in the hospital because she cannot deal with all the
problems at home. The mother is extremely preoccupied in deal­
ing with the impending loss of her son through marriage. Sonya
wants to leave her mother alone to handle this mourning. Her
being in the hospital also keeps the mind of her father constantly
on her, rather than on his wife's sorrow and pain. It is clear that
every time she improves a little bit, and you want to send her out
of the hospital, she has to get worse. Can you stop doing that?
Can you let her decide when she's ready to go?" The psychiatrist
and nurse, after a brief pause, agreed, saying, "Okay. We will
follow your suggestion." As the consultant was about to say
goodbye to the family, the mother asked, 'That's all you have to
say?" "Yes, thaf s all I have to say." "Don't you have any other
suggestion? Any other hospital she can go to? Any therapy to
do? Any shock therapy?" The consultant said, 'Thaf s what I
think. That's my idea as a consultant." The mother was incredu-
lous—"Thaf s what we came here for? We want action!" The
consultant responded, 'Thaf s all I have to say."
 IRREVERENCE IN INSTITUTIONS 39

When the consultant joined the group behind the mirror he

found the director, three other psychiatrists, and several nurses
all dressed in white coats peering at him very sceptically. The
consultant carried on with his unusual intervention, which in­
cluded maintaining a sense of logic and personal dignity with
the staff. In an attempt to engage the somewhat detached experts
who had been behind the mirror by appealing to their emotions,
the consultant made the following comments: "Did you notice
that when they were talking about the mother taking care of the
brother, the girl woke up a little bit? Also, during the session
when I said, 'The father is always thinking about her so he leaves
the mother alone', the girl was shaking her head a lot? And then,
when I said good-bye and tried to give her my hand, she re­
sponded a little by opening her eyes and looking at me for the
first time?" The staff appeared to be totally unimpressed by what
they saw as the consultant's primitive attempt at communicating
with a very sick girl by using magical and almost incomprehen­
sible words.
For three weeks the consultant received no news about the
patient and was reluctant to ask, not knowing what the hospital
staff thought about the interview. Then the psychiatrist called
and described what had happened, saying: "Something very in­
teresting has been going on. For three or four days, nothing
occurred. Then, the nurses began to notice small changes. Some­
one on the ward was getting up in the middle of the night, going
to the bathroom, then going to bed again. They suspect it was
Sonya but said nothing. After four days one morning she got
dressed by herself." The nurses were following the prescription
given by the consultant that if Sonya began to improve they
should ignore her completely. They did not say, "Oh nice of you
today. Good that you're up!" They ignored her completely, be­
coming irreverent to standard procedures.
The patient had improved, but now the attending psychiatrist
had another problem. What should be done about getting her
discharged, since the consultant's prescription prohibits the fol­
lowing of normal procedures? A decision was made to hold
another interview with the family and the staff. In the interview
the consultant asked Sonya, who was alert, properly dressed,
40 IRREVERENCE

and smiling, "Now that you have decided to be better what can
we do with these people here? They don't know what to do be­
cause I told them to ignore you and let you make your own deci­
sions. What should I tell them to do now?" She answered, "I
think I'll be ready to leave in two weeks. I want to go for the
summer vacation with my family." The consultant responded
saying, "Great, thafs O.K. with me, but I think we should work
together to plan your summer vacation because I am not sure
that your parents are up to the intimacy with you that unavoid­
ably will occur during family vacations."
After twenty minutes of negotiations the consultant and the
family came up with a plan. On Monday, Sonya will spend the
day with her sister. On Tuesday, the day with both her parents.
On Wednesday she would spend the day alone. Sonya could
visit her brother and hisfianceeon Sunday. From Thursday to
Saturday the family should act spontaneously. The little sister
would be responsible for keeping notes and making sure every­
one follows the rules.
Several months later the family came for a follow-up session.
Sonya was much improved and the brother had married. Father
and mother kept insisting that the family should continue the
session, which we agreed to do for six interviews to be held
every two months. After the third session Sonya had a relapse
and admitted herself to the same hospital. But she was able to
recover and be discharged after only two weeks. She was able
to recover and continued her successful differentiation.
In terms of irreverence, we have to realize that at certain times
in institutions a consultant is given total carte blanche openings
to do something unique. At that moment the hospital needed the
consultant's help. So they were able to be irreverent to their own
expertise and traditions by asking for a systemic consultation.
They were aware that their models were not useful to the patient,
and they needed the consultant because they did not know what
to do with her. They were desperate so they turned to an expert
therapist who they thought had some different ideas about how
to approach the situation.
The hospital director, being able to be irreverent to his own
inability to be helpful, allowed for the consultation. The consult­
 IRREVERENCE IN INSTITUTIONS 41

ant's ability to be irreverent to what appeared to be an impossible

case allowed him to survive the interview.
T o enter into such a powerful traditional context and attempt
to change an "impossible" case, the consultant had to be irrever­
ent to the superficial modesty that many therapists take pride in,
irreverent regarding the hospital staffs refusal to acknowledge
the clienf s ability to be decisive about her life and ability to de­
cide when she can leave. In response to the staff position Sonya
was very irreverent to their traditional efforts to help and to hos­
pital discharge procedures.
In order to analyse a situation fully and contextually, one
must look at the larger context in which the problem under ex­
amination is embedded. For example, in the case under discus­
sion the plan for the hospital to hire the consultant for a future
training course was a powerful context marker and complicated
the interview for the consultant considerably. The following are
some of the questions that were part of the consultanf s thinking:

1. A m I being tested before they hire me?

2. D i d they give me the worst case in the hospital so I would fail
and they would not have to hire me?
3. A m I, without knowing it, an instrument being used by a
faction loyal to the Milan School of Systemic Therapy within
the hospital to attack the more traditional psychiatric prac­
tice?

If you take seriously the first question you become anxious for
fear of failing the test. If you fall into the second trap you become
depressed over feeling rejected. If you take seriously the third
question you end up feeling paranoid. A s these questions were
passing through the consultanf s mind irreverence came to the
rescue.
Each institution is a different context, with different rules of
survival. Is the institution one that can afford to have its clients
get better? In private hospitals where the survival of the institu­
tion is dictated by the bottom line, the question of what is in the
best interest of the institution must be taken into consideration.
In certain institutions there almost seems to be an injunction
42 IRREVERENCE

against even being aware of what you are doing, it is as though

there is one right way to handle every problem.
Even in public institutions, there is a concern because there is
a need for patients to "stay open" (i.e. to remain available for
further treatment). If somebody improves too quickly the eco­
nomic viability in private institutions is threatened. In public in­
stitutions the patients are needed to maintain governmental and
political support. It is very important for therapists to acknowl­
edge these facts and to keep them in mind when working in such
contexts, rather than falling into the trap of complaining about
them. This too is an irreverent survival tactic.
We propose that one way to survive, to avoid becoming crazy
in the institution, is to become slightly irreverent. We strongly
believe that irreverence is a survival tactic that can work in both
institutional and out-patient settings. The longer the therapist
survives in an institution, the more he becomes a model to in­
spire the patient to survive without becoming a robot. Our posi­
tion is that we can only change ourselves; we are unlikely to
change the institution. But we can, within the confines of the
institution, demonstrate irreverence to the limitations inherent in
traditional diagnostic labels by helping the patient to experience
"expert descriptions" as but one of many alternative views (i.e.
to re-describe the described). We do not propose this as a revolu­
tion, rather as a way to survive the many conflicting messages
inherent in such contexts.

The overgrown boy

A 16-year-old boy and his family were seen during the boy's stay
in a psychiatric hospital. The boy had been hospitalized on and
off many times since the age of 12. He had been adopted at birth.
His mother had dedicated her entire life to him, whereas the
father had always had a cool and critical relationship with him.
When the boy reached puberty he began challenging and fight­
ing with his mother constantly.
 IRREVERENCE IN INSTITUTIONS 43

Between the ages of 11 and 12 he almost doubled in size, which

startled the mother. She became so worried about what she ex­
perienced as abnormal physical and attitudinal changes that
she began taking him to psychiatrists, most of whom spent time
coaching her on behavioural modification strategies and bio­
chemical treatment of the son. The more the mother attempted to
set limits with the boy, the more his behaviour escalated.
At one point during the boy's long treatment she discovered
him in his younger brother's room on top of his brother fully
clothed pretending to have sex with him. A week later, while the
father was away on a business trip, the mother awoke to discover
her son lying in bed with her, clothed in pyjamas, with his
arm around her waist. She became frightened, convinced he was
making a sexual advance towards her. She got out of bed, coaxed
him outside the house, then locked him out. The boy went to the
garage and got his father's axe, returned to the door, and
attempted to break it down. Hearing the turmoil, a neighbour
came over and calmed the boy down.
When the fatherreturnedhome the boy was hospitalized for
the first of many times. Over the next four years the adolescent
went through three hospitals. In the first he was both physically
and sexually abused by older adolescent patients. In the second
hospital he was taken out of the State by irresponsible staff mem­
bers and set up with a female prostitute. In the third hospital, the
patient was depressed and lonely and felt hopeless.
After three years of work with this patient and what turned
out to be a very supportive family, we summarized the case in
the following way: to the therapist it appeared that the mother
was over-involved with the son, always trying to control him,
setting limits, and then becoming very frustrated. The father
seemed absent much of the time. Talking to the mother, the
therapist hypothesized that she was tired of always having to
take care of the son. He believed that the mother wanted to take a
vacation from trying to control her son, but felt helpless to do so
unless "an authority" told her it was alright. The therapist pro­
posed to utilize her idea that he had this authority. Assuming
responsibility, he told her to take a temporary vacation from try­
ing to control her son. One consequence was a change in the
44 IRREVERENCE

family pattern. The father became more involved with the son as
he never could before.
One might view this instruction as a structural intervention;
however, the therapist had no such intent. No preconceived map
of how the family should look came into play. The idea for a
vacation came from the mother. Using her idea that she needed
permission, the therapist gave it.
Three years after entering therapy in the third hospital, the
boy was able to return to his home, is getting along well with
both his mother and father, and plans to enter studies at a uni­
versity in the autumn. He has a steady girl-friend and seems to
have survived all the "help" he got from professionals at the first
two hospitals.
In this instance the therapist responded to the parents' request
that he, as an expert, provide guidance for them. Here, the thera­
pist was irreverent to the ideas set forth by Goolishian and other
narrative-oriented therapists that the therapist should never take
an authoritative or directive position.

Incest between a mother and son

This case involved a 16-year-old boy who was in an institution.
The boy was brought to the attention of the juvenile court after
he had frequently run away and committed petty crimes in his
community. After he was admitted to an institution the follow­
ing story came out during a family therapy session. He reported
that before he began running away his mother had discovered
him in his parents' bed having sex with a 14-year-old neighbour.
When the mother discovered this she restricted him to the house
and started beating him frequently, usually with one of her
shoes. Then, after many individual and family sessions, the story
finally came out that the boy was having sex with his mother,
usually while the father was on the other side of the bed in an
alcoholic stupor.
For many months traditional therapy was attempted, with the
goals of trying to change the family system, create boundaries,
 IRREVERENCE IN INSTITUTIONS 45

and restructure the family. In individual therapy the incest was

frequently discussed in an attempt to help the boy work through
what was considered an extremely traumatic event in his life.
Over time, it looked as though this approach was not working.
The family continued to appear enmeshed and without bound­
aries. The more the therapist talked to the boy about incest, the
more depressed the boy became. Seven months into treatment,
the mother appeared at a family therapy session and reported
that this incest event never occurred. Several weeks prior to the
session she had gone through a religious conversion experience
in a Pentecostal church. She was certain now that the incest expe­
rience had been a bad dream—a message to her that she needed
Jesus in her life. The father, who had stopped drinking, reported
that he now kept a loaded .38 calibre pistol next to their bed. He
added that if the son came home again and ever attempted to get
into bed with his wife he would kill him. At that point, the boy
was not allowed to visit home.
By the mother reporting that the incest was a dream, it con­
fused the boy even more, because for him it was hard reality. He
was still stuck. At that moment, the therapist decided that his
approach was not working and tried to become irreverent to the
traditional approach. The therapist met with a training group he
was leading for a consultation. He was very frustrated with the
lack of progress in treatment and was worried about the boy's
future. A novel reframe emerged from the team consultation.
In the next individual session the therapist introduced the
reframe, asking the boy to compare the sexual experience he
had with the 14-year-old neighbour and the one he had with his
mother. The boy said he felt more relaxed and found the young
girl much more physically and romantically appealing than his
mother. In talking about the sexual encounters with his mother,
he said he was totally confused and "numb".
The therapist told him, very seriously, that the greatest, most
brilliant therapist ever, Sigmund Freud, the inventor of the prac­
tice of psychoanalysis, said that the fantasy of all men was to
sleep with their mother. Most men go through life, on some level,
even unconsciously, never being fulfilled because they think
their mother would have been the greatest sexual partner. The
46 IRREVERENCE

therapist continued, "It's fantastic that you discovered at a very

young age that this is a total myth. N o w you can have a very
exciting sexual life knowing that your mother was not the best
sexual partner for you. Most men never discover this, and for
those that do, it usually takes much longer than it has for you/'
After this new story was introduced the boy immediately
looked relieved. Treatment could move forward to the point that
the boy was able to leave the hospital and return to live with his
family. Was this some magical kind of metamorphosis?
The therapist had become irreverent against the traditional
form of therapy that insisted children involved in incest required
years of therapy to work through the trauma of such a devastat­
ing event. The traditional therapy was pushing the boy further
into depression, helping him feel like a deviant, a criminal, a
pervert. The therapist was willing to take the risk of questioning
the prevalent (and "politically correct") approach to the treat­
ment of incest by introducing this reframe, rather than sticking
with an approach that he realized was hurting the boy. This re­
describing of the situation helped the boy work his way out of
the institution and get on with his life.
Three years later the boy came back to the therapist for a
friendly visit. When questioned about his family he said that he
had left his family, had experienced many good sexual relation­
ships with other women, had joined the army, and was engaged
to be married.
In this case the irreverence does not lie only in the reframing
of the situation. It also involves being able to come out of
the traditional model while working with very serious circum­
stances. The institution was able to accept this kind of interven­
tion because at that point the staff was totally frustrated with the
lack of progress, and the goal of the institution was to help the
boy return to the community and lead a successful life.
W e need frequent consultation and dialogue with colleagues
to protect clients from the consequences of our own rigidity, and
to help us avoid becoming locked into one right story. Irrever­
ence is a flexible state of mind, which includes being irreverent
to reverence for one's own convictions.
 I R R E V E R E N C E IN INSTITUTIONS 47

To be irreverent is not easy. Sometimes the therapist has to be

patient, waiting until the time is right. The institution involved
must be at a point where, through frustration at their own lack of
progress, the staff can tolerate more dramatic interventions, as in
the case of Sonya and of the boy who was having sex with his
mother. In many instances there is a time of grace during which
change can happen in institutions, if the therapist can exploit
it. In both instances, if the therapist had used the irreverent
approach at the very beginning, he would have run the risk of
being discredited by the institution.
To reiterate, working in institutions is a lot like working with
families. You have to allow the system to push its own premise to
the point of absurdity. Organizations, regardless of size, are the
same in this respect. Families or larger organizations are all sys­
tems. There is a tendency towards rigidity or stasis and towards
self-correction. At the same time, it is equally important to re­
member that when therapists are committed so strongly to their
own premises that they cannot consider other ways of looking
at the situation, they get into trouble, blind to the moment of
grace and the opportunity for change. Following Prigogine and
Stengers (1984), we can speculate that all systems go through
periods of instability during which time change is possible. Un­
fortunately, many of us have been trained only to recognize and
describe stability. So we frequently miss the opportunities avail­
able to evoke change during chaotic states. We believe that irrev­
erence is a position that allows us to open our eyes to these
opportunities.
CHAPTER FOUR

Suggestions for training

"If s so easy to kill real people in the name of some

damned ideology or other, once the killer can abstract
them in his own mind into being symbols, then he needn't
feel guilty for killing them since they're no longer human
beings."
James Jones,
in a Paris Review interview with Nelson W. Aldrich, Jr.

lthough we each train and supervise separately and in

different contexts, we have found that the training
JL JL» problems we deal with are very similar. Furthermore,
our personal philosophies of supervision correspond. Despite
these similarities, fortunately no two of our training programs
are exactly identical. Gianfranco is Co-Director of a four-year
training program in systemic therapy with about 100 students, in
Milan, Italy. Gerry directs a small, private, two-year training pro­
gram in systemic therapy in Atlanta, Georgia. Wendel teaches

49
50 IRREVERENCE

and supervises systemic therapy in a two-year training program

with about thirty students, in Monroe, Louisiana.
Generally speaking the training models we have followed
reflected a fairly traditional approach, heavily influenced by
Gregory Bateson, Don D. Jackson, the Brief Therapy Project at the
Mental Research Institute, and, later, the influences of second­
order cybernetic and narrative epistemologists.
Trainees arefirstrequired to review the relevant theoretical
and clinical literature, spending an extended period of time read­
ing about first- and second-order cybernetics, systemic therapies,
narrative approaches, and so forth. Only after this lengthy period
spent on intellectual work and getting familiar with the ideas do
they begin their supervised live work with families. At this point,
we then begin to look closely at the trainees' epistemological
premises.
This is the traditional orientation to training students in a
model. This training strategy comes from a belief that being an
effective therapist requires a basic literacy in the existing knowl­
edge of cybernetic theory and clinical practice. We continue to be
convinced of the utility of a thorough knowledge of specific
models or orientations to practise before venturing into the more
complex and lively experience of clinical practice. This is where
you can begin to utilize the position of irreverence.
More recently, however, we have begun to expand our think­
ing about the traditional training approach, finding that it is often
effective to start the other way around. At a number of work­
shops where we have presented these ideas students voiced a
desire to begin immediately to practise therapy from a position of
irreverence before getting too bogged down in the tyranny of
different theoretical dogmas.
Isomorphic to the practice of therapy, training can begin with
asking students about their ideas about clients. Once students
begin to reflect upon their ideas about the case, and discuss with
other students their biases (which we prefer to call prejudices), a
confluence of different ideas begins to emerge. They begin to
become curious about other stories. We agree with Keeney and
Ross's position (1985) that the job of the trainer is one of gate­
keeping. To us gate-keeping is leading the group members to
 SUGGESTIONS FOR T R A I N I N G 51

articulate many different ideas and biases about the case, affirm­
ing each perspective, but then synthesizing the various hypoth­
eses and ideas in such a way as to be coherent with the specifics
of the case while at the same time offering different alternatives.
An important part of this process is to avoid getting bogged
down in the content of the plots offered by different trainees,
emphasizing instead the ability of each student to observe pat­
terns in the client's story. Like a master chef, the trainer's task is
to continue to stir the soup, breaking up symmetrical exchanges
when they appear. It is our experience that symmetrical ex­
changes occur when emphasis is given more to content than to
process. The trainer mixes together the ingredients of the conver­
sation, not dictating the direction but contributing to the emerg­
ing story. Of course, the trainer must at times honour his contract
with the trainees by exerting his position as instructor and being
the one who makes the final synthesis. But, ideally, we attempt
to create an egalitarian process.
A successful training group ordinarily starts out with the
trainer taking more of a traditional student-teacher role, being
more directive about which aspects of the emerging story will
prevail. As the group evolves the trainer is able to move to the
more collaborative role of gate-keeper.
One great value of this approach to training is that by ferreting
out the student's ideas initially, we can understand their per­
sonal prejudices immediately and they begin to understand their
own prejudices as well.
Like that of the philosopher Gadamer (1987), it is our belief
that the notion of prejudices is not in and of itself a negative
thing, and it is useful for therapists to understand where their
prejudices are. According to Gadamer:
It is not so much our judgements as it is our prejudices that con­
stitute our being. This is a provocative formulation, for I am
using it to restore to its rightful place a positive concept of preju­
dice that was driven out of our linguistic usage by the French and
the English Enlightenment. It can be shown that the concept of
prejudice did not originally have the meaning we have attached
to it. Prejudices are not necessarily unjustified and erroneous, so
52 IRREVERENCE

that they inevitably distort the truth. In fact, the historicity of our
existence entails that prejudices, in the literal sense of the w o r d ,
constitute the initial directedness of our whole ability to experi­
ence. Prejudices are biases of our openness to the w o r l d . T h e y are
simply conditions whereby we experience something—whereby
what w e encounter says something to us. This formulation cer­
tainly does not mean that we are enclosed within a wall of preju­
dices and only let through the narrow portals those things that
we can produce a pass saying, " N o t h i n g new w i l l be said here."
Instead we welcome just that guest w h o promises something new
to our curiosity. But h o w d o w e k n o w the guest w h o m w e admit
is one w h o has something new to say to us? Is not our expectation
and our readiness to hear the new also necessarily determined b y
the old that has already taken possession of us?
Before therapists are ever introduced to theoretical and clinical
models to be prejudiced by, it is helpful for them to understand
that they are already organized by the general prejudices they
hold. As Weakland says, the tendency for people to see what
they already believe is pervasive. Family therapy is very differ­
entfromother sciences for the simple reason that we are all, in
some way, experts about families. That is where we all grow up.
Family therapy is unlike sciences, such as the study of the physi­
ology of the human body, the study of astronomy, or other disci­
plines that require mastery of a larger body of knowledge not
familiar to most of us. In our profession, we hypothesize that
personal premises influence the model of therapy that people
choose. Prejudices are like heat-seeking missiles that home in on
models that confirm pre-existing views of the world.
It is amazing that in the therapy market-place any prejudice
can be developed into a theoretical model to be packaged and
sold to prospective followers. If you love thinking about family
history and are fascinated by diagrams you gravitate towards
Bowen. If you are fascinated by intricate plots, conspiracies, and
betrayal, you discover Selvini. If you are loyal to your grandpar­
ents' parents, you find Boszormenyi-Nagy. If you are still nostal­
gic about father being in charge, Minuchin or Haley are easily
available. If you believe that loss is fundamental, Norman Paul is
 SUGGESTIONS FOR TRAINING 53

the guy for you. If you believe it is all a matter of family develop­
ment you fall in love with Carter and McGoldrick. If you believe
oppressive patriarchies are the source of all evil, then Goldner
or Michael White are ready to offer a well-articulated theory. If
you are still a child of the 1960s and believe love conquers all,
Virginia Satir is your cup of tea. All of these people, and all other
inventors of therapy models, were brilliant masters at creating
elegant and useful approaches based upon some prejudice of­
fered by the culture.
These models have all been useful in helping many people,
students and clients alike. As clinicians and trainers, these preju­
dices and theories are all we have to work with. The post-mod­
ern position is to be able to employ a prejudice that is useful, to
discard prejudices when they are not useful, and to be able to
juxtapose other prejudices in forming hybrids.

How to traumatize a beginning therapist

Training is a very good context for supervisors and students alike

to become aware of and question their own prejudices. An exam­
ple comes to mind of the potentially profound consequences of
the supervisors' and students' fundamental premises. A young
female student in a marriage and family therapy programme
started working with clients at a centre that provided services to
battered women. A number of her first clients entered therapy
with incest as the presenting problem. The student became very
anxious, was easily upset, and became very unsure of herself in
therapy. The supervisor responded in what is becoming an all
too-frequent manner. As the student became increasingly anx­
ious, not knowing what to do in therapy with the emotionally
laden problem of incest, she experienced an empathic reaction to
the pain she saw in the clients. She became convinced that she
must have been a victim of incest herself when she was young,
even though she had no recollection of any event remotely re­
sembling an incestuous relationship at any time during her life.
54 IRREVERENCE

The intern began talking to anyone who would listen to her. A

number of her fellow students, several female faculty at the
school, professors, and a supervisor who adhered to one of the
prevalent psychodynamic models about incest, reinforced the in­
tern's self-interpretation that the only explanation for her emo­
tional upset when working with this population must be that she
was molested when she was young, and the traumatic experi­
ence was so terrible that she had blocked it out of her memory.
With very little supporting facts to substantiate such a theory,
and at the direction of her supervisor, the intern entered into
therapy with a therapist to help her uncover the alleged early-life
trauma so that it could be worked through.
After months of therapy focusing on helping her remember
the incest that "must" have occurred, she continued to have no
memory of such a trauma ever having happened. However, be­
cause an early trauma of molestation was the only explanation
seriously considered by the supervisor, therapist, and others in
whom the intern confided, she was continuously told that the
only way she would ever deal with the situation was through
intensive therapy focusing on helping her remember the trauma
so that it could be worked though. She must have been trauma­
tized when young. This was the only plausible way she could
explain to herself why she became so upset working with this
population.
An alternative explanation did exist to which no one gave seri­
ous consideration. The intern's emotional reaction is easily un­
derstood if the system theory premise that all behaviour makes
sense when thought about in context is applied. The trainee was
a young, sensitive woman who had no experience of working
with very emotional situations. Feeling intense compassion for
the clients and very unsure of herself, she read all the literature
on incest she could find to try to understand the situation. All of
these actions reinforced the popular theory that if something is
upsetting for someone, it may be a personal issue for him.
She was under the supervision of a supervisor who was con­
vinced of this dictum: if a clinician has difficulty with an issue,
it is evidence that it must be a personal issue. The beginning
 SUGGESTIONS FOR T R A I N I N G 55

therapist was reinforced at every turn with the idea that she
must have been molested in such a traumatic way that she could
not remember it. According to this theory, the less a person
can remember, the more traumatic the molestation must have
been.
The student, afraid of not knowing how to help her clients,
constantly worried that she might be doing more harm than
good. Under the tutorage of an individual therapist, who spe­
cializes in working with survivors of incest, this intern spent
months unsuccessfully trying to remember a trauma that in all
likelihood never occurred. Finally, after much money spent on
months of therapy, the father, who was paying for the therapy,
refused to fund any more treatment. In light of the trainee's abso­
lute failure in remembering a traumatic early-life molestation,
the therapist began to entertain with the intern the possibility
that she may never have been molested at all. Perhaps she was a
sensitive human being reacting intensely to the pain she saw in
the clients she was working with. One idea we have is that the
father's decision to stop paying helped the therapist change his
hypothesis that the intern was a victim of incest. Alternatively, is
it possible that the therapist interpreted the father's willingness
to pay for the therapy as an admission of guilt? Who knows, this
is just speculation.
What comments can we make about this case? According to
our biases both the therapist and the student believed in the real­
ity of their own prejudices so ardently that they became stuck.
Both therapist and student were caught in an inquisition to dis­
cover the truth, instead of seeing the intern's anxious behaviour
as a natural reaction to the problems of her clients, as a pattern of
communication between the intern and her clients. If you can
recognize the style of relationship materializing between an in­
tern and client as an emergent system, you can thenfinda way to
utilize it therapeutically.
Next, we will look at a training situation in which the intern's
prejudices were utilized by the team to create a therapeutic inter­
vention.
56 IRREVERENCE

The incompetent mother

A student in Milan emergedfroma session being conducted
with a mother and two unruly children to converse with her
colleagues behind the mirror: "I think this lady is totally incom­
petent to be a mother. She's very naive, she doesn't know what to
do to control her children." The team asked, "What do you want
to do?" "Well, I feel like helping her, giving her some instruc­
tions. She needs something, she doesn't seem to know any­
thing." To this announcement, the therapists and consultants in
the group replied: 'To give instructions to people does not work.
It is not helpful. It doesn't work." The debate behind the screen
continued: "I like to give instructions/Instructions are useless."
Theresolutionwas, "Okay, use this kind of difference and talk to
the patient about it." The student re-entered the therapeutic ses­
sion and stated, "Look, you were very successful in convincing
me that you are incompetent. I believe you, and I feel as if I
should give you some instructions. My colleagues behind the
mirror say to give instructions is useless, it is against their theory.
They have a systemic theory that doesn't permit them to think
that way. So I made a deal with my colleagues. They give me
permission to believe that you are incompetent, but only for
the next three months, and I must take the consequences of my
belief. In three months we will discuss it again." The therapist
then gave her some simple instructions. Three months later the
patient, who had been following instructions, appeared to be im­
proving in her behaviour. The student said: "My colleagues are
curious to know why you obeyed my instructions. In systemic
theory, people don't obey. Why did you obey?" To this the
patientreplied:"I obeyed because I like you better than I like the
people behind the mirror." The patient changed the level of the
conversation.
In this example the student therapist was irreverent towards
the idea that you cannot give instructions, even in therapy. By
saying, "My colleagues believe in systemic therapy...", she intro­
duced an element of playfulness. It is irreverent to say, "I choose
to believe that you are incompetent. You gave me this message
 S U G G E S T I O N S FOR T R A I N I N G 57

and I choose to believe, which is irreverent to the truth. There is no

truth in this situation. The question of incompetence or compe­
tence is secondary, it is part of a relationship. You convinced me
and I choose to believe; therefore, I'm irreverent towards my col­
leagues, who believe in systemic therapy." It is also expressing
irreverence towards the patient to say, "I believe you're incompe­
tent, but in reality, if s just a message that you give me".
Working with a team can be an efficient way to utilize the
resonance between what the therapist is experiencing and what
seems to be happening within the family. On many occasions,
however, therapists may not have the luxury of a readily avail­
able team. If a therapist is working alone, then it is important that
he is tuned into his own discomfort when the case is not pro­
gressing. Usually, the explanation for the lack of progress is
that the therapist is stuck in content and unable to see the pro­
cess. Alternatively, the therapist may have lost his ability to be
irreverent to his own prejudice and therefore lacks the capacity
for curiosity for different ways of thinking about the situation.
Or, the therapist may have become too obedient to the work con­
text in which he is practising.
With time therapists become aware of their idiosyncratic ways
of manifesting discomfort. Some therapists develop back pain or
headaches. Others become restless. Some have strong fantasies
of clients not showing up, or suffer self-doubt about not having
made the right choice of profession, and so forth. Whatever
symptom appears, the therapist can experience it as a cue to look
for help. We are absolutely sure that all therapists know at least
one colleague with whom they can discuss the case, or show a
videotape or audio recording to, or invite to observe a session.
It is our experience that no elaborate description or inordinate
amount of time is required to grasp the non-productive pattern
in which one is stuck. Usually such patterns are very similar. For
example, you want to control too much, so the patient goes out of
control. Or, you want to teach too much, so the patient becomes a
slow learner, and so on.
58 IRREVERENCE

The lady who could not stop coming to therapy

After two years of couple therapy, a couple was discharged from

therapy. Subsequently the wife called saying she wanted to talk.
She came in but had nothing of any apparent relevance to say.
The therapist handled it as a follow-up, and the woman left. She
returned again in six months, still with no problems but just
wanting to talk. Six months later she came again. Later she called
yet again, asking for another session. The therapist felt uneasy
about the case, so he asked permission from the woman to
hold the session in the presence of some colleagues, to which she
agreed. The therapist invited some first-year students to be ob­
servers and asked them to watch out for anything happening
that could explain the chronic therapy pattern.
About ten minutes into the session the students called the
therapist and said the situation was very clear to them. From the
behaviour of the therapist, the way he treated the couple, the
way he shook their hands, the position of sitting, expressions on
his face, and so forth, it was quite obvious that the therapist felt
sorry for them, especially the wife. This expression of empathy
based on pity could be an explanation for why the therapy could
not stop. The therapist, upon hearing this description, agreed
completely and was shocked that he had been unable to see
this pattern before. On most occasions it is not a question of re­
pression, or unresolved issues in your family, or whatever, that
makes you unable to see a pattern. What you are able to see
depends on the position you hold in the system. Culturally it is
quite easy for a therapist to experience himself as being a caring
person, without realizing that the caring can become pity, which
in turn subtly implies a disrespectful attitude towards the client,
which we call, in our jargon, negative connotation. We know that
the use of negative connotation can be an excellent glue to keep
people stuck to each other.
In fact, in situations where it seemed therapeutically appropri­
ate, we have suggested to parents who do not want to let their
children go, to mildly insult and put their children down ver­
bally to ensure that they never leave home. Of course the art of
insulting their children has been refined by parents over millions
 SUGGESTIONS FOR T R A I N I N G 59

of years. Therapeutic insulting is a finely honed skill—because if

too brazen, the clients never come back and you can't pay your
bills!

The sad young therapist

A young woman was involved in a clinical internship at a large
psychiatric clinic. She was studying at a university that strictly
adhered to the psychodynamic model of psychotherapy, and she
was expected to enter into psychodynamic clinical training. One
of the authors noticed this woman sitting alone in her office
one day looking dejected. When questioned about what was go­
ing on she replied that she had been training at the clinic under
the guidance of a psychodynamically oriented supervisor for the
past four months. Earlier in the day she had received one of her
first evaluations by her supervisor. The evaluation was to be re­
ported back to her university. In the report the supervisor com­
mented that at this point in her training she had been unable to
engage clients in the initial phase of long-term, insight-oriented
therapy. Many of her cases were seen for only four to six ses­
sions, during which she and the patient felt the problems had
improved. The supervisor viewed this as indicating the intern's
lack of ability to engage people in a long-term therapeutic rela­
tionship so that insight into their psychopathology and repeti­
tive problematic patterns could be brought forth and worked
through.
The intern reported that she was very hurt and confused
by this. Based on this feedback from her supervisor she was
even contemplating dropping out of the training and university
altogether. The author, realizing he might be crossing a super­
visory boundary, nevertheless felt it might be useful to this de­
moralized beginning therapist to share a story that might help
her feel better.
He said it looked like she had developed a natural and intui­
tive ability to work briefly with clients. However, in order to gain
professional credentials, she must complete the degree pro­
gramme at the university, as well as the internship training under
60 IRREVERENCE

the direction of her current supervisor. His recommendation to

her was, for the moment, to attempt to learn the psychodynamic
model that many people, including patients, view as having great
value—a model from which you can take ideas—and a model
which, hopefully, she could draw from throughout her career.
On the other hand, it was hoped she could maintain her natural
and intuitive ability to work briefly with people without creating
tremendous dependency on her for ideas and insights. His opin­
ion as a supervisor was that this gift is rare and, in many ways,
the clinical practice that could result from it is far more sophisti­
cated than traditional psychodynamic therapy. Yet, at the same
time she was encouraged to try to have some kind of belief in her
supervisor and the psychodynamic model during the next two
years in order to complete her training.
To us, this story represents the use of what we described
earlier as temporary certainty, where the student, in order to com­
plete (one might say survive) the training program, must tempo­
rarily believe in it for the necessary time. At the end of that time
she would have the freedom to recoup her natural gifts for brief
therapy.

The temporary anorexia of a student

A young student was talking to a couple of middle-aged parents

after their two daughters had been asked to leave the session.
One of the daughters, aged 17, had been anorectic and had been
slightly improving for some time. The general opinion in the
supervision group behind the mirror was that the couple was
always so involved with the daughters that they had no time to
enjoy themselves together.
The therapist was asking routine questions such as what they
were going to do when their daughters become independent, or
how their leaving would affect their relationship, and so forth.
The parents seemed to agree with the opinion of the therapist
that their life was somewhat empty without the children. But,
just at that moment, the husband revealed that he was planning
to invite the wife to the opera the next week and he expected to
 SUGGESTIONS FOR TRAINING 61

enjoy it. The therapist immediately snapped: "I don't believe you
will, you are so used to being only parents that it is hard to imag­
ine you enjoying yourself without the children." The people
behind the mirror began to worry. Soon after, the mother men­
tioned that the day before she had taken her husband shopping
for the first time and they almost enjoyed themselves. Again, the
therapist responded saying: "I don't believe you enjoyed your­
selves. You have never done that before!"
The therapist was immediately called behind the mirror and
asked to describe what she felt about the couple. She said "I
think they are making fun of me. They really have nothing
between them and are only trying to show me how they can
function without the children, but I don't believe them." The
therapist talked in a frenzy for about five minutes. When the turn
to make comments came to the observing group, one of the mem­
bers said: "It is very clear to me that our colleague has taken the
place of Maria, the anorectic daughter, who for years has been
interfering with the life of the parents any time they wanted to do
something without her."
The therapist was struck by this observation and left the room
without comment. A few minutes later she appeared in the
therapy room where she said to the couple: "My colleagues be­
hind the mirror noticed that I behave like your daughter when I
say that I don't believe you can enjoy yourselves without her. I
would like to ask you to end this session now because I fear that
if we stay here I am going to do it again. My wish to do it is
stronger than I am and I need some time to overcome the temp­
tation to do it again." Smiling, the husband and wife got up,
hugged her, and left saying: "Please give our regards to your
friends behind the mirror."
A month later they came back, again alone, and began a lively
conversation with our therapist who, this time, was talking in
a very comfortable manner with the couple. The conversation
touched upon many interesting subjects. We discovered that the
life of these two people was much richer than anyone in the
therapeutic team had imagined. The question was now: Who
had made the change—the couple or the therapist?
CHAPTER FIVE

Some considerations for research

"If a man cannot forget, he will never amount to much/'

Kierkegaard, Either/Or

ne does not have to look at research as an attempt to find

the truth. Our position is that we will never find the
essence of psychopathology, or human suffering, but
that the research data is always useful in terms of building hy­
potheses.
One of the apparent dangers of post-modern thought is the
implication that all existing theories are no longer held to be
"true", and, therefore, they become useless. Post-modernism
suggests that we should question all things. And yet we find
great value in traditional research logic in as much as it is like
any other perspective, any other belief. The question is not
whether it is true, but whether we can make use of it in the prac­
tise of therapy.
We could say our reality is a very well organized, self-verify­
ing experience, with which we must deal every day, whether or
63
64 IRREVERENCE

not it exists separate from ourselves, or is created by us. Still

it is the reality we describe, in which we can find patterns, rules,
repetitions.
When we conduct research, then, or when we study the exist­
ing research findings, we can use these "findings" as hypo­
theses. One is naturally careful not to carry these "findings" or
"truths" to an extreme point of view, where one attempts to fit
the family into a claimed research "truth". One has the freedom
to look at a researchfindingas a useful idea, and at the same time
be able to discard it if it does not fit a family or client.
Suppose a therapist is working in a traditional setting—for
example, a shelter for battered women—and the professionals
there have access to all of the statistical research available on
battered women. If a person comes from a family in which the
father was involved in an incestuous relationship with that per­
son, and his father was involved in an incestuous relationship
with him, and they all happen to drink too much and have been
labelled alcoholics by an expert, then, on the basis of that
research, the therapist "knows" that not only is the client at the
shelter a battered person, but also probably an alcoholic and pos­
sibly a child abuser. This is an example of an "empirical" para­
digm that can become a predominant model for working with
incest. By and large, front-line therapists do not see research
findings like those described above as generalizations or hypoth­
eses. Rather, far too often such research findings are accepted as
"truth" handed down from above—something that is not to be
questioned.
For instance, take a therapist who never reads research, who
works with the same clients, and who never diagnoses them as
having tendencies for alcoholism or child abuse. This therapist
could appear incompetent to colleagues more versed in research
stories, regardless of how capable he is in working with this
population.
From an irreverent perspective, how can we handle the kind
of empirical data outlined above? If you begin to believe too
strongly in the truth of the research, then you run the risk of
creating a self-fulfilling prophecy. It is dangerous to believe too
ardently in research constructions, seductive though this maybe,
 S O M E C O N S I D E R A T I O N S FOR R E S E A R C H 65

especially if your institution values these findings. It can also be

dangerous to avoid research out of fear of falling in love with the
findings, and thus losing the ability to see humans rather than
research probabilities.
The danger is not in the research but in the notion that
if a therapist believes too ardently in the research findings, as
though it is truth, then he is unable to see anything else. When
looking at the client's family, it may come out that the grand­
father and mother were alcoholics. The belief of the therapist
then is that there is a great chance that the client will become an
alcoholic. In therapy with this client, the therapists may auto­
matically perceive him to be an emerging alcoholic. The clinician
loses the ability to see the client from any other perspective. The
clinician, in this case, tends to see only things about the client
that match the research, losing interest in being curious about
other aspects of the person. His head is so full of prejudices from
the research that he could end up co-constructing psychopathol­
ogy that does not even exist in the client's experience.
Let us use another example. Margaret Hoopes and James
Harper (1987) have written several excellent books on sibling
position indicating that research shows that certain patterns of
behaviour are evident in children according to whether they are
thefirst-born,second-born, third-born, etc. Reading this book a
therapist can find the conclusions fascinating. A danger we see is
that people can become one-dimensional caricatures of human
beings. The script that assigns roles to the children should come
from the family and not from a research book, no matter how
frequently a given script shows up in different families. We want
to appreciate the research rather than worship at its altar.
There are two prevalent types of research: quantitative and
qualitative. There are many quantitative research studies—such
as those that have focused on the phenomenon of alcoholism—
that have studied the number of children who become alcoholics
whose parents were alcoholics, or the number of children abused
by parents who become abusing parents, and so forth. When
we look at studies such as these, we also have to remember
that there is another percentage of people who do not become
alcoholics or abusers. Our curiosity is directed towards the ex­
66 IRREVERENCE

ceptions, who cannot not exist and are equally important, per­
haps even more so.
Then there is descriptive or qualitative research such as re­
search that describes certain relationship patterns prevalent in
specific family organizations such as single-parent families.
Such data might highlight the forming of a more marriage-like
relationship between a parent and child, for example; or, the
relationship between acting-out behaviour of children and the
sharing of parental responsibility in blended families.
It is important to take into consideration that these two types
of research can be useful to the process of building and testing
hypotheses.
If a therapist has training in traditional research and then is
trained to be slightly irreverent all the time, some very interest­
ing research could result. When as a therapist you see a client,
instead of looking at how he or she fits the existing research, you
should look for how the client disobeys the rules of research. You
can train yourself to look at how clients do not fit the data—at the
exceptions. In the case an of alcoholic, you could say to the client,
'The research says you are supposed to be an alcoholic. How
come you're not?" Or, "How does it feel to have all these experts
predicting you are going to become a hopeless alcoholic? Or an
abuser?" Or, "How respectful do you think you have to be to this
evidence?" Or, "How loyal a citizen are you to the prevailing
culture?" Thus, the therapist and the client can becomes curious
about what does not fit the research, rather than have their be­
haviour dictated by statistics that by their very nature relate to
conglomerates of populations and could have nothing to do with
a specific human being sitting in the therapist's office.
Irreverence often involves sailing against the prevailing wind.
Not just to be oppositional, but to have the freedom as therapists
to look for things in the family that the research does not empha­
size (i.e. adaptive capabilities, resources, etc.). In this way we
become very curious about the exceptions to the predominant
data informing our work. This is an idea that also underlies the
work of such people as John Weakland (1989), Steve De shazer
(1982), and Michael White (1989).
 S O M E C O N S I D E R A T I O N S FOR R E S E A R C H 67

At the same time as being irreverent therapists, we must

also feel free to take the empirical data seriously. People with
integrity devote their lives to the study of family systems and
their data should always be considered as a valuable source of
hypotheses in the field, not just as some researcher's construc­
tion.
Traditional research is useful in making generalizations about
large populations, but says very little about individual families. It
is, however, an excellent resource for analysing the cultural con­
text in which the family exists.
What we would love to see are studies of the deviations of
research data. In other words, we need more research studying
families where, for example, the parents are alcoholics and the
children do not become alcoholics; or families where parents are
totally uneducated, the father is an alcoholic, and the child ends
up going to Harvard. This kind of research, we think, would
broaden our view of family organizations. Traditional research,
by its very nature, tends to flatten complex systems like families
by bringing forth what is common and predictable.
Let us suppose for the sake of argument that 80% of children
of alcoholics become alcoholic, and very often the one who
comes to the office is one of this 80%. Believing this to be true, the
therapist now becomes confirmed in his opinion, then transmits
this idea to the client, even a sober client. We tend to forget the
other 20%, as though they do not exist because there is no re­
search about them. Remembering about the deviations from the
research data is not always easy. We must keep in mind, learning
from the constructivist position, that we bring forth what we
believe.
Much of present-day research places an extraordinary amount
of emphasis on statistical studies, such as, "How many people
become this way? . . . What are the similarities in background of
people who become this way? ..." etc. We would like to propose
research asking questions such as: "How come many children
from so-called severely dysfunctional families turn out fine?"
Or, "What kind of patterns of relationship exist in the so-called
problematic family that can be held responsible for producing
68 IRREVERENCE

children that do well?" This kind of research would give insight

into which aspects of the system to work with and amplify. This
would be one way to conduct research on phenomena that have
been described in systemic theory in terms of "multi-finality and
equi-finality". How can people coming from very similar begin­
nings end up being very different, or come from very different
beginnings end up having very similar problems.
We enjoy looking at the exceptions, the nonconformists, the
people who drink heavily or have had psychotic episodes and
are extremely productive in other aspects of their lives. We
believe that some of the most insightful research on exceptions
now exists in the field of literary biographies where the excep­
tions as well as problems are examined and contextualized. For
example, the author William Faulkner, who drank heavily into
the night and is rumoured to have had several love affairs, and
yet remains one of America's premiere novelist. Or, the states­
man Winston Churchill, who seemed to go out of his way to
break all taboos about eating, drinking, and smoking and yet
lived an extraordinarily productive and long life.
One criticism of this kind of research proposal might be that as
therapists we should be concerned about "pathology". After all,
some would say that we are in the business of helping people
overcome "pathology". One response to this concern is the idea
that pathology is, in large part, constructed in the relationship
between the myths, prejudices, and beliefs held within the larger
culture about what is healthy or not healthy, beautiful or ugly,
moral or immoral; and the individual's struggle to make sense of
and survive within these often contradictory injunctions. Obvi­
ously, the therapist is in a unique position to help co-construct
"pathology", or to dissolve it. The convictions and prejudices of
the therapist and client alike are part and parcel of the construc­
tion.

An example

One of the authors designed a research project in Milan to see

if just asking circular questions, without the use of other inter­
ventions, with a family in a session had an effect on future
 S O M E C O N S I D E R A T I O N S FOR R E S E A R C H 69

behaviour. Some students from the Milan School of systemic

family therapy contacted three different Public General Hospi­
tals in the area, each with twenty-bed psychiatric units and each
attached to active out-patient services, and asked the administra­
tors if a research could be conducted. The administrators agreed
and even offered to fund it. Twenty patients with a diagnosis of
schizophrenia of at least two year's duration, between the ages of
18 and 25, all heavy users of the hospital's services (pharmaco­
logical, in-patient, and out-patient) were chosen at random for
participation in the research. They all had been under pharmaco­
logical as well as psychological therapy for some years, includ­
ing individual, group, and family therapy for some.
How the research was to be presented to the staff and to the
clients was deemed crucial. The question to be asked was formu­
lated as follows. To the doctor in charge we asked: "Can you let
your patient be part of a research project?" We posed the same
question to the families. "By asking simple questions, the re­
search is going to inquire, Why has this particular person in this
family became a patient?" We emphasized to both the physician
and the family that we were conducting research, and not doing
any therapy. We stressed that we did not want to help anybody.
Rather, we just wanted to conduct research and needed their
cooperation in answering a few questions.
A group of expressed-emotion researchers (EER, an instru­
ment and method for measuring affect in families and individu­
als) were asked to examine the families before, in the middle of,
and at the end of the research project. The study was to last six
months, with one encounter with the family once a month. The
EER examiners would also interview a control group consisting
of twenty families with similar diagnosis not involved in the
study. The two groups—the research students and the EER
people—did not have contact or communicate with each other
during the entire research project.
We anticipated that the families would be reluctant to partici­
pate since no therapy was being offered and there was no ob­
vious pay off for them. At the beginning of the project, it was
surprising that although one family refused to participate, the
others were very happy to come. Possibly the latter were so tired
70 IRREVERENCE

of being therapized that they found research a relief, or feared

sanctions if they did not cooperate with the institution on which
they depended heavily. The research therapists also enjoyed their
work, possibly because they were not responsible for providing
therapy. They did not have to make hypotheses and interven­
tions. After 45 minutes of asking circular questions, the sessions
were ended with a simple statement: "See you in a month."
The questions asked during the interviews were the classical
Milan circular questions, such as:

1. Who is closer to whom?

2. How did the relationship between mother and father change
since the patient decided to become schizophrenic?
3. What changes do you expect if you decide to get better?
4. Who would be more upset?
5. Suppose your sister took your place what would happen?

The therapists were organized in teams of two, one in the

therapy room and one behind the one-way mirror. The job of
those behind the mirror was to control the wish of the therapist
in the room to give interpretations, injunctions, or rituals to
the family. This was a very difficult task because the therapist's
temptation to do something "therapeutic" was sometimes over­
whelming.
About half-way through the project a point was reached, dur­
ing a regular meeting of the research group, where the interview­
ers complained of extreme frustration at being forbidden from
doing something to help. The supervisor was convinced that
they had to try to keep faith to the non-interventive nature of the
research project. By the time the project ended, however, it was
apparent that the rule had probably been broken on a few occa­
sions. In one instance, for example, it was discovered after the
fact that one interviewer could not help himself from making the
following statement to a family: "If we were not doing research I
would give you the following suggestions" (then a few sugges­
tions specific to that family were offered). "But don't do any­
 S O M E C O N S I D E R A T I O N S FOR R E S E A R C H 71

thing about it because we are only doing research, not therapy"

(a classic paradoxical statement).
The result of the research was a dramatic reduction of rehos­
pitalization for the schizophrenic members during the research
period—62% fewer relapses than the control group. Further­
more, there was a significant lowering of expressed emotion in
the research group. There was a 5% drop-out rate at the end of
the period, compared to 25% in the control group.
What we learned from this experience was the following. It
is hard for a clinician to distinguish between when he is doing
therapy and when he is doing research. The clinician is always
watching what the effects of his actions are on the client, and
comparing them with what he already knows. Therefore, in one
sense, his actions or interventions could be called research. The
researcher cannot avoid being drawn into co-constructing a new
reality as soon as he gets in touch with a human system. There­
fore, he becomes a clinician. Was this project therapy smuggled
as research? Or was it research smuggled as therapy?
CHAPTER SIX

Random closing meditations

Why is it possible to learn more in ten minutes about the

Crab Nebula in Taurus, which is 6,000 light-years away,
than you presently know about yourself, even though
you've been stuck with yourself all your life?
Walker Percy, Lost in the Cosmos.

A s we reflect back on this journey we have taken to­

gether, we find to our surprise how conservative the
idea of irreverence really is. Sailing in these sometimes
remote and choppy waters, we find that on occasion we yearn
for the safe harbours that some of our predecessors represent for
us.
And so, as this irreverent excursion comes to an end, we find
ourselves reflecting upon the many brilliant and creative people
who have influenced our thinking and practice and to whom
we would like to pay tribute. Gregory Bateson, with his brilliant
stories. Who can equal the wisdom that he shared in his life?

73
74 IRREVERENCE

Don Jackson, whose spirit and influence pervades not only our
own orientation, but the entire field of family therapy which he
helped create. Harry Stack Sullivan, the too-often overlooked in­
ventor of interpersonal thinking, the first to recognize that we are
all much more human than anything else, and the well from
which so many people have drawn sustenance. R.D. Laing,
with his total honesty and ability to see the knots into which
all humans are capable of getting entangled yet not even be
aware of. Freida Fromm-Reichmann, another near-forgotten
but profoundly influential figure in the pre-history of family
therapy. Milton Erickson, with his utter conviction that we can
help people change. Jay Haley, who continues to keep the flame
of strategic theory burning in the face of the strong winds of
the narrative movement. Harry Goolishian, who has the ability
to bring the field of family therapy almost to a standstill with
the simple, yet beautiful, reminder that we must not forget to
listen to people again before we impose solutions. Mara Selvini
Palazzoli, with her incredible belief in the power of therapy as
well as her forceful conviction that man is a strategic animal.
John Weakland, with his keen perceptive and conceptual abili­
ties, helping us to appreciate the profoundly playful implications
of the dictum that "One thing leads to another". Lynn Hoffman,
with her ability to synthesize many complex ideas and put them
into a comprehensible, if sometimes controversial, form.
As is so often the case with many enjoyable conversations as
they wind down, yet another interesting notion comes to mind—
that of oscillation, the pendulum-like experience that many of
us experience during our careers between total cynicism (for ex­
ample, of the traditional, biological orientation to psychiatry)
and a naive enthusiasm for such beliefs as the almost magical
potency of therapeutic strategy. Our position reflects the desire
not to be so naive as to think we can change all the problems our
clients face, but at the same time not to fall into the cynical trap
that we can do nothing when faced with difficult problems.
Rather, to have the freedom to take action. To somehow be able
to survive the devastation and disappointment that sometimes
inevitably occurs in the course of dealing with the tragedies of
 R A N D O M CLOSING MEDITATIONS 75

living. To be able to keep going and not lose hope, able to

find humour in the absurdity of seemingly impossible situations.
Nurturing our capacity for enthusiasm and excitement even
though at times we fail. This book has been an effort to describe
some of our strategies for survival.
REFERENCES AND BIBLIOGRAPHY

Anderson, H., & Goolishian, H . (1988). Human systems as linguistic

systems: Preliminary and evolving ideas about implications for
clinical theory. Family Process, 27,371-393.
Anderson, H., & Goolishian, H . (1990). Beyond cybernetics: Comments
on Atkinson and Heath's "Further thoughts on second-order family
therapy." Family Process, 29,157-163.
Bateson, G. (1972). Steps to an Ecology of Mind. New York: Jason
Aronson.
Cecchin, G. (1987). Hypothesizing, circularity, and neutrality revisited:
A n invitation to curiosity. Family Process, 26,405-413.
Cox, H . (1969). The Feast of Fools. New York: Harper.
De shazer, S. (1982). Brief Ecosystemic Family Therapy. New York: W.W.
Norton.
Elkaim, M . (1990). // You Love Me, Don't Love Me: Constructions of Reality
and Change in Family Therapy. New York: Basic Books.
Fromm-Reichmann, F. (1950). Principles of Intensive Psychotherapy.
Chicago, IL: University of Chicago Press.
Gadamer, H. (1987). Philosophical Hermeneutics. Berkeley, C A : Univer­
sity of California Press.

77
78 REFERENCES A N D BIBLIOGRAPHY

Gergen, K . (1991). The Saturated Self. New York: Basic Books.

Goldner, V. (1988). Generation and gender: Normative and covert hier­
archies. Family Process, 27 (March), 17-31.
Haley, J. (1967). Advanced Techniques of Hypnosis and Therapy: Selected
Papers of Milton H. Erickson. New York: Grune & Stratton.
Hoffman, L. (1990). A constructivist position for family therapy. The
Irish lournal of Psychotherapy, 1 (9), 110-129.
Hoopes, M . , & Harper, J. (1987) Birth Order and Sibling Patterns in Indi­
vidual and Family Therapy. Rockville, MD: Aspen.
Jackson, D., (1963). The Sick, the Sad, the Savage, and the Sane. Paper
presented as the annual academic lecture to the Society of Medical
Psychoanalysts and Department of Psychiatry, New York Medical
College.
Keeney, B. (1983). Aesthetics of Change. New York: Guilford Press.
Keeney, B. (1982). Not pragmatic, not aesthetic. Family Process, 429-434.
Keeney, B., & Ross, J. (1985). Mind in Therapy. New York: Basic Books.
Laing, R. (1985). Wisdom, Madness and Folly: The Making of a Psychiatrist.
New York: McGraw-Hill.
Lane, G., & Russell, T. (1987). Neutrality vs. social control: Systemic
approach to violent couples. Family Therapy Networker. 11 (3), 52-56.
Lane, G., & Schneider, A . (1990). A therapeutic ritual of respect.
Zeitschrift fur Systemische Therapie, 8,103-108. Also in Journal of Fam­
ily Ttierapy, 12 (3), 287-294.
Maturana, H., & Varela, F. (1980). Autopoiesis and Cognition: The Realiza­
tion of the Living. Dordrecht: D. Reidl.
Paglia, G (1989). Sexual Persona. Cambridge, M A : Yale University
Press.
Palazzoli, M . , Boscolo, L., Cecchin, G., & Prata, G. (1978). Paradox and
Counterparadox. New York: Jason Aronson.
Prigogine, L., & Stengers, I. (1984). Order out of Chaos. New York: Ban­
tam.
Ray, W. (1991). The interactional therapy of Don D. Jackson. Zeitschrift
fur Systemische Therapie, 9,2-25.
Ray, W. (1992). Our future in the past: Lessons from Don D. Jackson for

the practice of family therapy with hospitalized adolescents. Family

Therapy, 19 (1), 61-71.

Sluzki, C. (in press). The "Better-Formed" Story.

Sullivan, H.S. (1953). The Collected Works of Harry Stack Sullivan. New

York: W.W. Norton.

 REFERENCES A N D BIBLIOGRAPHY 79

Von Foerster, H . (1981) Observing Systems. Seaside, C A : Intersystems

Publications.
Weakland, J. (1989). Personal interview with Wendel A. Ray. Palo Alto,
CA: Mental Research Institute.
Webster's New Universal Unabridged Dictionary, 2nd ed. (1983). Cleve­
land, O H : Dorset & Berber.
Whitaker, C. (1976). The hindrance of theory in clinical work. In
P. Guerin (Ed.), Family Therapy: Theory and Practice (pp. 154-164).
New York: Gardner Press.
White, M . (1989). Selected Papers. Adelaide: Dulwich Centre.
INDEX

AIDS, 17
Churchill, W., 68

alcoholism, 64, 65, 66,67

circular question, 68, 70

Aldrich, N. W., 49
Cox, R , ix, 77

Allen, W., 1
cybernetically oriented therapist, 16

Anderson, H., 6,77

cybernetics:

anorexia, 60
first-order, xiii, 6,50

second-order, xiii, 6,50

Bateson, C , 4,5, 36,50, 73, 77

bonding:
Deshazer, S.,66, 77

male, 15
deontology:

male-female, 30
definition, 8

Boscolo, L., 78
ethical, 8

Boszormenyi-Nagy, I., 52

Bowen,M., 3,16,52
Elkaim, M , 77

Brief Therapy Project at the Mental

epistemology, narrative, 6,50

Research Institute, 50
Erickson, M. H., 3, 74, 78

expressed-emotion research (EER), 69

Carter, B., 53

case examples:
family:

beginning therapist, 53-54

organization, 67

catatonic girl, 36-37

systems, 67

faeces-eating boy, 33
therapy, as hard science, 2

famous "but not rich" psychiatric

Faulkner, W., 68

patient, 35
feminist position, on violence, 14

homicidal lady and polite therapist,

feminist therapist, 16

17
first-order cybernetics, xiii, 6, 50

incest between mother and son, 44

Freud, S.,45

incompetent mother, 56
Fromm-Reichmann, F., 74, 77

lady who could not stop coming to

therapy, 58
Cadamer, H.,51,77

midsummer night's dream, 26-30

gate-keeping, 50

nowhere man, 21
genogram, 2

overgrown boy, 42-43

Gergen, K., 78

passionless couple, 19-20

Coldner, V.,6, 53, 78

punishment as treatment, 23-24

Goolishian, H., 6, 7, 44, 74, 77

sad young therapist, 59

Greene, G., 31

temporary anorexia of student, 60

Cuerin, P., 79

therapist who became father, 22

Castro, R, 9
Haley, J., 52, 74, 78

causality, circular nature of, 15

Harper, J., 65, 78

Cecchin, C , ix, x, 49, 77, 78

Hoffman, L., 6, 74, 78

child abuse, 13,24,64

Hoopes, M , 65, 78

80
 INDEX 81

incest, 13,15, 44-45, 4 6 , 5 3 , 5 4 , 5 5 ,

r a p e , 15, 34

64
r e v e n g e for, 24

institutions, irreverence i n , 31-47

R a y , W . A . , x , 49, 78, 79

instrumentality, 6
revenge, 24,29

i n s u l t i n g , t h e r a p e u t i c , 59
R o s s , J . , 50, 78

i n t e r p e r s o n a l t h i n k i n g , 74
R u s s e l l , T , 78

irreverence, systemic, 9

S a t i r , V . , 53

Jackson, D . D „ 2,50, 74,78

s c h i z o p h r e n i a , 69

J o n e s , J . , 49
S c h n e i d e r , A . , 78

s e c o n d - o r d e r c y b e r n e t i c s , x i i i , 6, 50

K e e n e y , B . , i x - x i , 6 , 5 0 , 78
S e l v i n i P a l a z z o l i , M . , 5 2 , 74, 78

K i e r k e g a a r d , S., 63
s e x u a l p a s s i o n , a n d v i o l e n c e , 15

s i b l i n g p o s i t i o n , r e l e v a n c e of, 65

L a i n g , R . , 74, 78
s i n g l e - p a r e n t f a m i l i e s , 66

L a n e , G . , i x , x, 4 9 , 78
S l u z k i , C . , 78

s o l u t i o n - f o c u s e d t h e r a p y , 16

m a l e b o n d i n g , 15
s p o u s e b a t t e r i n g , 13

m a l e - f e m a l e b o n d i n g , 30
S t e n g e r s , L , 4 7 , 78

M a t u r a n a , H - , 6, 78
s t r a t e g i c t h e o r y , 74

M c G o l d r i c k , M . , 53
S u l l i v a n , H . S., 74, 78

M i l a n S c h o o l of S y s t e m i c T h e r a p y , 16,
systemic irreverence, 9

37, 3 8 , 4 1 , 6 9 , 70
s y s t e m i c t h e r a p i e s , 50

M i n u c h i n , S., 52

m o v e m e n t , n a r r a t i v e , 74
t h e o r y , s t r a t e g i c , 74

M R I [ M e n t a l Research Institute, P a l o
t h e r a p e u t i c i n s u l t i n g , 59

A l t o ] , 16,50
therapist:

c y b e r n e t i c a l l y o r i e n t e d , 16

narrative epistemology, 6,50

f e m i n i s t , 16

n a r r a t i v e m o v e m e n t , 74
n a r r a t i v e - o r i e n t e d , 44

n a r r a t i v e - o r i e n t e d t h e r a p i s t , 44
therapy, family:

non-instrumentality, 6
as h a r d s c i e n c e , 2

s y s t e m i c , 50

paedophilia, 24,25
t h i n k i n g , i n t e r p e r s o n a l , 74

P a g l i a , C . , 1 4 , 1 5 , 30, 78
t r a i n i n g , 49-61

p a r a n o i d s y n d r o m e , 35

p a t r i a r c h y , 15
Varela, F.,6,78

P a u l , N . , 52
v i c t i m / v i c t i m i z e r d i c h o t o m y , 14,17

P e r c y , W\, 73
violence, 13-30

P r a t a , G . , 78
f e m i n i s t p o s i t i o n o n , 14

prejudice, 1 6 , 2 9 , 5 0 - 5 3 , 5 5 , 5 7 , 6 5 , 6 8
i n t e r p e r s o n a l , 13

u n d e r s t a n d i n g , 51
a n d s e x u a l p a s s i o n , 15

P r i g o g i n e , L . , 4 7 , 78
s y s t e m i c o r i e n t a t i o n o n , 15

psychiatric hospitals, irreverence i n ,

V o n F o e r s t e r , H . , 6, 79

31

W e a k l a n d , J . , 11, 5 2 , 6 6 , 74, 79

psychodynamic model, 54,59,60 W h i t a k e r , C , 7, 79

W h i t e , M . , 6 , 5 3 , 66, 79

q u e s t i o n , c i r c u l a r , 6 8 , 70

ABOUT THE AUTHORS

Gianfranco Cecchin, M .D., is co-founder of Milan Systemic Therapy,

one of the most influential family therapy models practised today.
C o - D i r e c t o r of the C e n t r o M i l e n e s e D i Terapia D e l i a F a m i g l i a ,
M i l a n , Italy, he is w o r l d - r e n o w n e d for his pioneering w o r k i n
f a m i l y therapy. H e is author a n d co-author of n u m e r o u s journal
articles a n d books, i n c l u d i n g the classics Paradox and Counterparadox
a n d Milan Systemic Therapy.

Gerry Lane, M . S . W . , is i n private practice a n d is the Director of

F a m i l y T h e r a p y at H i l l s i d e H o s p i t a l , A t l a n t a , Georgia. A u t h o r of
a n u m b e r of journal articles and b o o k chapters, he has presented
w o r k s h o p s throughout E u r o p e a n d the U n i t e d States. H e has
gained w i d e recognition for his pioneering use of cybernetic a n d
systemic orientation i n research a n d clinical practice w i t h couples'
violence. In recent years he has devoted m u c h of his time e x p a n d ­
i n g the use of the systemic orientation i n psychiatric a n d other
institutional settings.

Wendel A. Ray, P h . D . , is a Research Associate a n d Director of the

D o n D . Jackson A r c h i v e at the M e n t a l Research Institute, P a l o A l t o ,
C a l i f o r n i a . H e is C o - F o u n d e r of The F a m i l y T h e r a p y Institute
of L o u i s i a n a , a n d an Associate Professor of M a r r i a g e a n d F a m i l y
T h e r a p y at Northeast L o u i s i a n a U n i v e r s i t y i n M o n r o e , L o u i s i a n a .
A n A A M F T C l i n i c a l member a n d supervisor, he is author of m o r e
than 25 journal articles and book chapters a n d has presented
n u m e r o u s w o r k s h o p s across the U n i t e d States. H e is President of
the L o u i s i a n a Association for M a r r i a g e and F a m i l y T h e r a p y .

82
Irreverence: A Strategy for Therapists' Sun/ival m a r k s the e n d result of
a c o l l a b o r a t i o n b e t w e e n three creative a n d highly respected t h e r a ­
pists a n d writers in the f a m i l y t h e r a p y f i e l d . It c o n t i n u e s the t r a d i t i o n
of the M i l a n g r o u p a n d later systemic thinkers by e x a m i n i n g the way
a t h e r a p i s t ' s o w n t h i n k i n g c a n b l o c k the process of t h e r a p y a n d lead
to f e e l i n g stuck. The a u t h o r s define a n d d e m o n s t r a t e the use of a
c o n c e p t in the t h e r a p e u t i c field - irreverence - w h i c h a l l o w s t h e r a ­
pists t o free themselves f r o m the limitations of their o w n t h e o r e t i c a l
s c h o o l s of t h o u g h t a n d the f a m i l i a r hypotheses they a p p l y to their
client f a m i l i e s . They illustrate their ideas with s o m e very c h a l l e n g i n g
f a m i l y t h e r a p y cases a n d i n c l u d e a n interesting c o n s u l t a t i o n with the
staff c a r i n g f o r a hospitalised patient. The b o o k also extends the
n o t i o n of irreverence b e y o n d t h e r a p y to the fields of t r a i n i n g a n d
research w h e r e its a p p l i c a t i o n is b o t h fresh a n d p r o f o u n d .

' . . . i t is difficult t o write a b o u t this t o p i c w i t h o u t a p p e a r i n g f l i p p a n t o r

sarcastic a n d the o p e n i n g c h a p t e r only just m a n a g e s to a v o i d this
problem. H o w e v e r , the clinical vignettes m o r e t h a n c o m p e n s a t e .
This is a c o m p a c t b o o k . . . a n d o n e of the excellent Systemic T h i n k i n g
a n d Practice Series e d i t e d by D a v i d C a m p b e l l a n d Ros D r a p e r . It
is a b o o k f o r therapists of all levels of e x p e r i e n c e , since it c o n t a i n s
clues o n h o w t o a c q u i r e w i s d o m /
Peter Reder, Journal of Family Therapy,
Volume 16, No. 3 1994

A volume in the

Systemic Thinking and Practice Series

Series Editors: David Campbell and Ros Draper

C o v e r Illustration: Abstract 16 by Robert Railton

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