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    Book Title: eTextbook: Mastering Competencies in Family Therapy

    Systemic–Strategic Family Therapy


    Making a Connection: The Therapeutic Relationship

    Making a Connection: The Therapeutic


    Relationship

    Respecting and Trusting the System

    Systemic therapists respect the family as a system, as an entity that has its

    unique epistemology, or way of knowing and understanding the world. They


    have a deep, abiding trust that the system can reorganize itself without the
    therapist forcing change. Instead, the therapist provides opportunities for the
    family to reorganize itself. The symptoms are never seen as indicators of

    individual pathology but rather as the by-product of family interactional


    sequences that have served a purpose.

    Adapting to Client Language and Viewpoint

    In the first meeting, the therapist tries to establish a positive, trusting


    relationship with the client (Nardone & Watzlawick, 1993; Watzlawick et al.,
    1974). One approach is to adapt to the clients’ language, communication style,
    and worldview, speaking logically with clients who focus on reason and more
    intensely with clients who have a more emotional manner of expression. First
    and foremost, the therapist respectfully engages with the client’s
    representational framework or epistemology, including beliefs, values, and
    language. This is the inverse of traditional psychoanalysis, in which the client
    must adapt to the language and viewpoint of the therapist.

    Neutrality

    In 1978 (Selvini Palazzoli et al., 1978; Selvini Palazzoli et al., 1980), the Milan
    team first described their therapeutic stance as one of neutrality, which has
    been one of the most misunderstood concepts related to their work (Boscolo et
    al., 1987). For the Milan team, neutrality connoted not only nonpartiality
    toward particular family members or problem descriptions but also
    multipartiality, the willingness to honor all perspectives.

    In one sense, neutrality refers to the pragmatic effect the therapist has on the
    family, not the therapist’s own feelings (Cecchin, 1987). Thus if, at the end of the
    session, the family cannot identify which “side” the therapist took, then the
    therapist has had the effect of being neutral. However, during the session, the
    therapist often appears to take a side by asking questions that align with a
    certain person’s view of the problem; the therapist must counterbalance this by
    asking questions that align with each of the other perspectives so that at the

    end the therapist is viewed as neutral.

    Neutrality also implies not becoming attached to particular meanings,


    descriptions, or outcomes (Boscolo et al., 1987). The Milan team carefully

    avoided buying into any one description of the problem, including their own.
    Neutrality extended to their own hypotheses and ideas about the family, and

    they avoided “falling in love” with their own ideas. Later, Cecchin et al. (1992)
    characterized this form of neutrality as a form of irreverence (discussed in next

    section) that allows for broad maneuverability. When therapists do not rigidly
    adhere to a particular problem description, they can see more possibilities for

    intervention rather than focusing on the single solution that fits with their
    preferred hypothesis.

    Irreverence

    The concept of irreverence was not highlighted until later in the literature

    (Cecchin et al., 1992), but—when properly understood—it clearly captures the


    therapist’s relationship to the problem (not the client). The magic of this

    approach is derived from the therapist’s irreverent relationship with problems.

    What is there to be irreverent about? Systemic therapists are irreverent

    regarding the “catastrophic” appearance of problems. They do not give in to


    the appearance that a person has a “personality flaw,” “illness,” “unresolved
    childhood issue,” or other deep, troubling problem, even though problems

    appear that way, especially to those who live with them. But the systemic
    therapist knows that appearances are deceiving because problems are

    intimately connected with the relational and broader social context. In a


    different context, a person’s problem behaviors would be different. The context

    and problem are always influencing each other. The art of irreverence is to not
    honor the problem as a mighty foe and assume it has more power than it does.

    Its power is entirely dependent on its context. With experience, the therapist is
    able to see through the appearance of a “big, horrible” problem and instead see

    that the person, problem, and context form a fluid dance—and experience
    teaches that by changing only a few steps in the dance, the problem shifts,

    diminishes, and eventually disappears.

    Irreverence is felt in the therapist’s confidence and unpanicked response to

    problem issues. It is driven not by disrespect but rather by fearlessness.


    Whatever problem the client brings—whether the loss of a child or a teen’s

    drama of the week—the therapist remains fearless, maintaining a deep sense

    of calm and faith in systemic processes, knowing that the problems are never
    as insurmountable as they appear and that systems are inherently self-

    correcting. Irreverence does not imply lack of empathy or sensitivity. Rather, it


    allows the therapist to maintain an openness, creativity, and flexibility to

    provide maximum benefit to the client. In this chapter’s case study, the

    therapist’s irreverence toward 16-year-old Alba’s decision to start drinking and


    smoking pot after their parents separated keeps the therapist from being

    overly panicked about the acting-out behaviors and enables the family to focus

    on the issue: Alba’s sense of betrayal and loss. This breach of trust is

    compounded by the father’s negative reaction to their identity as nonbinary 2


    years earlier. By not overreacting to the drinking and drugs—but not ignoring

    them either—the therapist gives them less power and creates space for the

    more critical issues of betrayal and loss.

    Maneuverability
    Maneuverability refers to the therapist’s freedom to use personal judgment in

    defining the therapeutic relationship (Nardone & Watzlawick, 1993; Segal,


    1991; Watzlawick et al., 1974). Therapists may choose to maintain an expert

    position or a one-down stance (see next section), depending on what would be

    most helpful to the family. Similarly, the therapist may be more distant or more

    emotionally engaged, depending on the circumstances. Furthermore, the


    therapist may choose to be disliked by the client or be the “bad guy” in order to

    achieve the desired change in the family system, always attuned to whatever

    role might be most beneficial for the family.

    The One-Down Stance, or Helplessness

    The one-down stance is used to increase clients’ motivation, often

    paradoxically by claiming, “I’m not sure if I am able to handle such a problem”

    (Segal, 1991). This move is often helpful with clients who act as if their situation

    is hopeless; when the therapist takes the hopeless stance, the client is
    motivated to find hope. Systemically this works because in most systems there

    is a counterbalance: if one person is hopeless, the other feels compelled to be

    hopeful to maintain a balance. This same dynamic is also observed between

    couples in crisis: generally one person will manage the crisis, allowing the
    other one to more fully feel the panic and trauma.

    Beyond serving this paradoxical purpose, the one-down stance also expresses a

    certain attitude toward the family system. Systemic therapists view the system
    as an entity with its own rules and integrity that must be respected, much like a

    mountain climber must respect the awesome forces of nature or the sailor an

    ocean. Like a family system, nature and the ocean are not things the therapist

    can control; instead, there is a deep respect for their power and ways. Thus, the
    one-down stance is a sincere and genuine position for a systemically trained

    therapist.

    Social Courtesy
    Haley (1987) describes the initial stage of therapy as the social stage, a time
    during which the therapist engages in casual social conversation, about the

    weather or traffic, to make clients comfortable and reduce their sense of

    shame: “the model for this stage is the courtesy behavior one would use with

    guests in the home” (p. 15). Before discussing the problem, the therapist
    ensures that all members have been properly greeted. During this first social

    stage, the therapist is assessing interactions and mood (Haley & Richeport-

    Haley, 2007).

    Collaboration

    Influenced by second-order cybernetics and social constructionist theories,

    contemporary systems therapists adopt a more collaborative relationship with

    clients (Tomm et al., 2014). Rather than assume a strategic posture by trying to

    directly effect change, contemporary systemic therapists use reflexive


    questions designed to facilitate client self-healing, in which the therapist and

    client co-create new meanings and action (Gaete et al., 2014; Tomm, 1987a).

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