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the Dulwich Centre website
... a gateway to narrative therapy, community work and psychosocial support Dulwich Centre Publications Pty Ltd
www.dulwichcentre.com.au
Reflecting Teamwork as
Definitional Ceremony
by Michael White
Chapter 7 from: White, M. 1995: Re-Authoring Lives: Interviews and Essays. Adelaide: Dulwich Centre Publications.The tradition of working with therapeutic teams, and the use of one-way screens in this work, is one that is well established in the field of family therapy. Many of the early developments in this sort of teamwork were pioneered by the Milan Associates, and by the faculty of the Ackerman Institute of New York. According to this tradition, the members of the team remained behind the one-way screen and were ever invisible to the people who were consulting them. It was the team’s role to develop systems hypotheses - about the ‘family system’ and about the ‘therapeutic system’ - and to plan interventions, based on these hypotheses, to be delivered by the interviewer. Whatever the merits of this way of structuring team participation, and whatever the subsequent developments in theorising this work and in team focus, the autonomy and anonymity of the team raised various issues of an ethical and political nature that a number of therapists - including many of those who had played a significant role in the evolution of this tradition - began to confront.
In 1987 Tom Andersen of Norway published his paper The Reflecting Team: Dialogue and meta-dialogue in clinical work. This introduced the family therapy world to a very different conception of therapeutic teamwork, and to a very different notion of team member participation. These developments were enthusiastically embraced by many therapists who appreciated the possibilities associated with working with therapeutic teams, but who had found the ethical issues raised by the autonomous and anonymous team increasingly difficult to ignore. Karl Tomm was one of these therapists, and he introduced me to the notion of the reflecting team in the late 1980s. Karl, ever alert to new possibilities in this work, and becoming increasingly concerned about ethical issues in the field, had arranged to meet with Tom Andersen to get some first-hand exposure to ‘reflecting team’ work. He had come away from this meeting greatly enthused, and encouraged me to explore reflecting team structures in my own work. In response, I expressed some concerns - at least I half expressed some concerns, because I don’t think that I quite knew how to put them very adequately in the first place - and raised some questions. I later managed to get my thoughts more organised around some of these concerns and questions, and they came out like this:
1. I had no difficulty in appreciating the fact that the reflecting team format could be a very powerful experience for people consulting therapists, but powerful in what sense? I had witnessed first-hand, on many occasions, the powerfully negative effect that the openness of the traditional ward-round can have on ‘patients’ in psychiatric hospitals. So I was sure that there wasn’t anything intrinsic to the openness of the reflecting team format that would necessarily render it therapeutic in its effects. What form might reflections take, I wondered, in order to mitigate the possible negative effects of this openness?
2. I was acutely aware of the fact that, in the culture of psychotherapy, most of the interactions between therapists and people who consult them are informed by the discourses of pathology. These discourses inform taken-for-granted ways of speaking about people’s lives and relationship practices that have the effect of marginalising and objectifying people who seek help. What sort of requirements on reflecting team practices would be necessary to undermine this potential for marginalisation and objectification?
3. More specifically, I was familiar with the penchant of many family therapists to engage in the time-honoured structuralist and functionalist analyses of the events of people’s lives. Among other things, these analyses and the operations associated with them have the effect of elevating expert knowledge claims to ‘truth’ status, and of disqualifying the knowledges of persons who consult therapists. So I could see a potential for the reflecting team context to be one that was maximising of both the imposition of the ‘truth’ claims of the professional knowledges and the disqualification of alternative claims. What guidelines might be established for reflecting teamwork that could provide for some check on this, guidelines that might minimise the possibilities for this disqualification, that might limit the possibilities for imposition?
4. I had a degree of awareness of the extent to which the culture of psychotherapy is not peripheral to mainstream culture - of the extent to which it is not exempt from dominant structures and ideologies, and of the extent to which it plays a central role in the reproduction of these structures and ideologies (for example, just take the link between the misogyny of dominant culture and the mother-blaming of the culture of psychotherapy). In the light of this, could we trust that the reflecting team, in its operations, would not also be complicit in this reproduction, and that it would not unwittingly contribute further to the very forces that provide the context for the problems that people seek consultation over? Certainly such trust would be misplaced. So, what reflecting team processes might be instated to address this vulnerability to the reproduction of some of the negative aspects of dominant culture?
Over several years, I have received various responses to my expressions of these and other concerns. Some therapists have suggested that I am making the whole idea of reflecting teamwork too complicated, and that I should learn to trust the ‘intuitiveness’ of team members. But I could not be convinced of this. To be intuitive is to enter into a discourse of understanding and practice that is considerably informed by what might be called ‘folk psychology’. This is not to suggest that intuition can’t be positive in its effects on people’s lives, but I don’t believe that it should go unexamined. I have no doubt that a study of the history of intuition would be illuminating of a particular system of understanding and acting in the world - that we would find many discontinuities in what counts as intuition through time, and that we would be confronted by many examples of the extent to which yesterday’s intuition so often seems like today’s folly. To encourage team members to ‘trust’ their intuition would be like encouraging one to simply have faith in their own good intentions, which often isn’t a very good idea at all.
Other therapists suggested that I could resolve my concerns by simply leaving it to team members to express the subjective experience that emanates from the ‘centre’ of their being. What about this notion of unexamined expression of experience? Is there such a thing as a pure expression of subjective experience? Can any expression of experience avoid the mediating effects of systems of understanding? Can any expression of experience in language stand outside of what it is that language constructs? Can any expression of one’s experience within a community of persons be recognised by others standing outside of a system of meaning that provides for the response that we call recognition? Not likely! Besides, the whole idea of people having a centre through which they can express their essential self does not stand up at all well to close analysis.
Yet other therapists suggested that notions like Habermas’ ‘ideal speech community’ might relieve me of some of the burden of these concerns. But this didn’t work at all well for me. I had some familiarity with this notion, but could not see how any community could possibly be exempt from the various relations of power of our culture and its institutions, including those based on gender, race, class, opportunity, age, sexual preference, economics, and so on. I had long held the view that it is through the recognition of these relations of power, not through a denial of them, that action can be taken to challenge them and reduce their toxicity, and that any such actions themselves play a part in relations of power. Because of this, I was more attracted to Foucault’s critique of the notion of an ideal speech community than I was to the original proposal:
The thought that there could be a state of communication which would be such that the games of truth could circulate freely, without obstacles, without constraint and without coercive effects, seems to me to be Utopia. It is being blind to the fact that relations of power are not something bad in themselves, from which one must free one’s self. I don’t believe there can be a society without relations of power, if you understand them as means by which individuals try to conduct, to determine the behaviour of others. The problem is not of trying to dissolve them in the utopia of a perfectly transparent communication, but to give one’s self the rules of law, the techniques of management, and also the ethics, the ethos, the practice of self, which would allow these games of power to be played with a minimum of domination. (Foucault 1988, p.18)
The questions and the concerns that I had were stubborn (and they still are, they just won’t go away). But I continued to wrestle with them, because I remained enthusiastic about the transformative potential of reflecting teamwork, and because my early explorations of this format were mostly reinforcing. In this paper, I will describe a reflecting team structure that has evolved (a) through further explorations of these concerns, (b) in response to the comments of the many therapists who have stepped into reflecting teamwork at Dulwich Centre, and (c) from the feedback I have received about this work from people who have consulted me within these contexts.
During this discussion, I will not be referring to other conceptions and developments of reflecting teamwork because of a lack of familiarity with these. I have no doubt that other therapists have also been addressing concerns and questions similar to those I have outlined above, but I’ve not had the opportunity to catch up with their proposals and their translations of these into practice. And I don’t know how Tom Andersen has responded to such concerns and questions, as it has not so far been possible for me to consult him about this, and I do not have a first-hand account of his work.
Now for a cautionary note. In the work that I will be describing here, I am not at all certain that I have yet satisfactorily addressed the sort of concerns and questions that I have outlined above, and I also acknowledge that there are many other concerns and questions that can be raised. So I would appreciate it if readers were to read this paper as an account of work in progress.
DEFINITIONAL CEREMONIES
Sometimes conditions conspire to make a generational cohort acutely self-conscious and then they become active participants in their own history and provide their own sharp, insistent definitions of themselves and explanations for their destiny, past and future. They are then knowing actors in a historical drama they script, rather than subjects of someone else’s study. They “make” themselves, sometimes even “make themselves up”, an activity which is not inevitable or automatic but reserved for special people in special circumstances. (Myerhoff 1982, p.100)
There exist many candidate metaphors for the sort of reflecting teamwork that I will be introducing in this discussion. To the extent that the reflecting teamwork that I am describing here establishes ‘conditions that conspire’ to engage people as ‘active participants in their own history’ and in ‘making themselves up’, I believe that Barbara Myerhoff’s ‘definitional ceremony’ provides a particularly appropriate metaphor for this work, and serves to clarify some of the processes involved in it.
Myerhoff used this metaphor to describe some of the activities of an elderly, poor, and neglected Jewish community in Venice, Los Angeles. Because the people of this community were relatively invisible to the wider community, they were deprived of important reflections on their own lives, and at risk of becoming invisible to themselves - at risk of doubting their very existence. It was by ‘definitional ceremonies’ that the people of this community countered this threat. These ceremonies provided for these people an ‘arena for appearing’ and for ‘opportunities for self - and collective proclamations of being’:
Definitional ceremonies deal with the problems of invisibility and marginality; they are strategies that provide opportunities for being seen and in one’s own terms, garnering witnesses to one’s worth, vitality and being. (Myerhoff 1986, p.267)
Myerhoff calls attention to the critical role that the ‘outsider-witness’ plays in these definitional ceremonies. These outsider witnesses are essential to the processes of the acknowledgement and the authentication of people’s claims about their histories and about their identities, and to the performance of these claims. The participation of the outsider-witnesses in definitional ceremonies gives ‘greater public and factual’ character to these claims, serving to amplify them and to authorise them. The outsider-witness also contributes to a context for reflexive self-consciousness - in which people become more conscious of themselves as they see themselves, and more conscious of their participation in the production of their productions of their lives. The achievement of this reflexive self-consciousness is not insignificant - it establishes a knowing that ‘knowing is a component of their conduct’, making it possible for people to ‘assume responsibility for inventing themselves and yet maintain their sense of authenticity and integrity’, for people to become aware of options for intervening in the shaping of their lives.
I believe that the ideas and the practices associated with the sort of reflecting teamwork that I will be describing in this paper introduce similar possibilities for the establishment of a reflexive self-consciousness and for participation in the authoring of one’s own life. And I also believe that an understanding of the mechanisms of transformation in definitional ceremonies can serve to inform therapists of some of the more critical components of this work. This is certainly the case in the development of an understanding of the significance of team members as ‘outsider witnesses’ in pushing forward the plot.
These old Jews ... (in) ... separating the curtains between the real and unreal, imagined and actual, to step across the threshold and draw with them, pulling behind them, witnesses who find, often to their surprise, that they are somehow participating in someone else’s drama ... Having stepped over threshold, they become the “fifth business”, witnesses who push a plot forward almost unwittingly; their story is not wholly their own but lives on, woven into the stuff of other people’s lives. (Myerhoff 1986, p.284)
GENERAL ORIENTATION
My experience of reflecting teamwork is limited to training contexts at Dulwich Centre and at workshops elsewhere. For many of the therapists attending these programs, this will be their first introduction to the notion of the reflecting team, and to reflecting team practices. Because of this, I find that it is helpful, at the outset, to provide them with a general orientation.
As part of this orientation, I tell visiting therapists that they will be discouraged from theorising about the ‘truth’ of the problems that people bring to therapy. Instead, it will be their task to attend carefully to the discussion that is taking place during the interview. I also inform them that I will be discouraging them from the idea that it is their role to prepare and to deliver some intervention into people’s lives or into the ‘system’. It is not the task of team members to ‘strategise’, to ‘problem-solve’, to ‘teach’, to ‘role- model’, to ‘perturb’, or to advise.
Therapists are informed that engaging in the activities that are associated with this theorising and with the preparation of interventions will subtract from a consciousness of the privileged nature of their position in three senses of this:
1. The privilege that is granted to team members by those people who open their lives to others in the course of this work - an act of inclusion that reflects an extraordinary act of faith and of trust in the therapeutic team.
2. The privilege that relates to the personal location of team members in terms of the social order - in responding to the events of their own lives, team members so often have options for action and lifestyle choices that people who consult them more often than not do not have.
3. The privilege, in terms of power, that team members enjoy within the therapeutic context - there is an inherent imbalance of power in therapeutic contexts that favours therapists and team members, regardless of the various measures that might be taken to render these contexts more egalitarian.
Also, as part of this orientation, it is my habit to provide visiting therapists with some general guidelines about the nature of the responses that are expected of the reflecting team. It will be their task to interact with each other and with those people who are seeking consultation in ways that are:
1. Informed by a degree of consciousness of the privileged nature of their position in the context of this work.
2. Acknowledging of people’s experiences of the problems over which they are seeking consultation, of the dilemmas that they have faced, and of the struggles that they have engaged in over their efforts to change what they have wanted to change in their lives.
3. Provoking of people’s fascination with certain of the more neglected aspects of their lives, aspects that might provide a point of entry for the generation and/or resurrection of the alternative stories of their lives.
4. Situating of their own responses within the context of their own personal experience, imagination, purposes, curiosity, and so on.
STRUCTURE OF THE MEETING
When I am working with reflecting teams, I usually propose that the meeting be structured in four parts, with each part constituting an interview in itself. In the first part, the interviewer meets with the people who are seeking consultation, while the team members take their position as an audience to this conversation. At this time, team members can be behind a one-way screen, viewing the session on closed circuit television, or can be in the interviewing room but sitting back from the interviewer and the people who are seeking consultation. At the outset of the interview, people are given the option of meeting the team members before getting started, or of meeting them as they introduce themselves prior to commencing their reflections in the second part of the interview. As well, people have the option of taking away with them a list of the names of team members, and details of their workplaces.
In the second part, the interviewer and the people seeking consultation switch places with the team - they now become the audience to the conversation that takes place amongst the team members. During this time, team members reflect on, and actively interview each other about, their experiences of the first part of the meeting - that is, in the first interview. This constitutes the second interview. On occasion, some have experienced difficulty entering into interactions with each other in this way, and have tended to direct their reflections to the interviewer and to the people who are now in the audience role - the idea of having a conversation with team members about the lives of others while in their presence breaks most of the rules about therapeutic encounters. However, these team members soon become more relaxed with, and enthusiastic about, these third-party conversations once they have had the opportunity to hear from people first-hand about the beneficial effects of the opportunity of witnessing one’s life being spoken about so respectfully in one’s presence.
In the third part of the meeting, everybody switches place again, and the interviewer interviews the people seeking consultation about their experiences of the first interview and the second interview, with the team again taking up the audience position. This constitutes the third interview.
In the fourth part of the meeting, the interviewer, the team members, and the people seeking consultation get together to debrief and to engage in a deconstruction of the therapy itself. This constitutes the fourth interview.
I will here provide some details about the peculiarities of the second, third and fourth interviews. In doing so, I intend to assume some familiarity with the general therapeutic practices that I refer to. I have discussed these practices in some detail in various publications, and would prefer not to reiterate them in this paper.
Second Interview: Four Classes of Response
1. Joining
Team members introduce themselves, explain their presence at the consultation, and provide brief details to locate themselves in the field (e.g. workplace, projects, interests, etc.) so that they do not remain anonymous to the people who are seeking the consultation. Rather than doing this by way of a round, it is usually more helpful for team members to make this introduction just before engaging in their first response. This way, people are not overwhelmed by details about the identities of reflecting team members, but are able to link these identities to the interests of these team members as they introduce themselves across the course of the meeting.
Team members ensure that all of the persons seeking consultation are acknowledged. This can be achieved, in part, by one or two members of the team providing some account of their understanding of (i) the circumstances that have led people to seek the consultation, and (ii) these people’s experiences of these circumstances. Apart from experiencing acknowledgement at this time, the people seeking consultation develop an understanding of the understandings that team members have about their predicaments, and about this they can give feedback to the team members at a later stage in the meeting.
2. Mystery
Team members respond to these developments that have been judged by the people, during the first interview, to be preferred developments - that is, those sparkling moments, exceptions, unique outcomes, or contradictions that were identified during the first part of the meeting. Alternatively, team members can respond to those developments that they believe might constitute preferred developments to the people seeking consultation - but, in this case, care is taken to acknowledge the fact that this response remains in the realm of speculation until confirmed or refuted by the people concerned.
Team members respond to these preferred developments as one might respond to a mystery - one that an outsider can be curious about, but one that only those people with the inside knowledge can satisfactorily unravel. In making this response, team members convey their faith in the ability of people to unravel these mysteries of their lives, even if this cannot be achieved instantaneously and independently, but over time in collaborative projects with interested parties. These preferred developments provide points of entry to the alternative stories of people’s lives.
Orienting to mystery in this way is generative of the curiosity of team members and, in turn, this curiosity is provocative of a fascination in people for some of the previously neglected but significant experiences of their lives.
3. Alternative Landscapes
Those preferred developments that are generative of the curiosity of team members can be considered points of entry or gateways to the alternative stories of people’s lives. These alternative stories provide access to alternative knowledges about ways of being and thinking in the world. To assist people to step through these gateways, so that they might explore some of the possibilities that are before them for the re-authoring of their lives, at this stage in the second interview team members traffic in ‘landscape of action’ and ‘landscape of consciousness’ questions. As I have provided considerable information about the development of these questions in various publications, I do not intend to provide an overview of this here. However, I will provide some examples of landscape of action and landscape of consciousness questions taken from reflecting team interactions so that readers might have some sense of how these go in this context:
Team Member A: I found that my attention was very much captured by the steps that Simon initiated here to challenge some of the old habits that have been quite dominant. Was this interesting to anyone else here? - because I would really like to talk about this some.
Team Member B: I also had a sense that these were important steps. It left me wondering about how Simon had prepared the way for these steps, because I’m sure that they didn’t just come out of the blue. Did anyone here notice anything that would give some clue about this?
Team Member C: Perhaps. Early in the discussion, I heard Anne say something about Simon doing a bit more exercising. Perhaps this was something that he was doing to get ready for these steps.
Team Member D: Yes, I was interested in the fact that Anne brought this to our attention here today. This acknowledgement seemed important to Simon, and this gave me some sense of what Anne’s contribution to these developments might be.
Team Member B: What do you think these developments reflect about what Simon wants for his life, and what do you think they say about this mother/son relationship?
Team Member A: Perhaps that Simon is interested in having options for his life, perhaps that he wants to be able to take good care of his life, perhaps that he has some idea about having a bit more to say about how his life goes.
Team Member B: And what about the qualities in the mother/son relationship?
Team Member D: This is a good question. Simon and Anne are listening to our conversation, and I wonder what their answer to this question might be? My guess is that they could tell some interesting stories about the history of their relationship that would illustrate these qualities.
Team Member C: I’ve had some thoughts about what these qualities might be.
In this example, team members first interact with each other around landscape of action questions, then reference landscape of consciousness questions to their speculation in the landscape of action, then reference landscape of action questions to their speculation in the landscape of consciousness, and later go on from here in the zigzagging fashion that I have described elsewhere. All of this is for the purposes of opening options for Anne and Simon to thicken and more deeply root some of the counterplots of their lives.
Throughout this second interview, the people sitting behind the one-way screen become more fascinated by some of the alternative landscapes of their own lives. They speculate about the answers to these questions and, in the process, achieve some clarity in their own thoughts about the different connections between some of the neglected events of their lives, and about the counterplots that these connections suggest.
As readers will note, the reflecting team process is one in which team members actively interview each other - it is not a process that can be described as ‘pointing out positives’. This work is not based on the tradition of behaviourism - it is not founded on the notion of positive reinforcement.
Reflecting teamwork based on the notion of positive reinforcement can so easily degenerate into a barrage of disconnected comments which can be confusing and disorientating for people. As well, under these circumstances, reflecting team members can be experienced as patronising and out of touch with the realities of people’s lives. Further, it is not at all difficult for people to think that team members are ingenuine, just trying to be positive in order to ‘jolly them along’. And as well as all of these hazards, team members usually find it tedious to be operating in this way. In their reflections they frequently find themselves ‘reinventing the wheel’, and that their conversations are reduced to a level of banality, in which one superlative is exchanged for another. Although I caricature this sort of reflecting team conversation here, I have been informed that at times they come perilously and embarrassingly close to this in actuality:
Team Member E: I was really impressed by this development.
Team Member F: Yes, me too. But don’t you think that this other development was simply stunning?
Team Member G: Look, I know that these developments were really good, but there was this other event that was clearly exceptional.
Team Member H: Yes, I agree, and would like to offer my congratulations on this. But I must tell you that I was really blown away by the news of what happened when they got together on this. Blown away, I tell you.
Team Member I: Wow, me too. Umm, ummm ... [searching for other superlative, and thinking about trying ‘over the moon’ or maybe ‘volcanic’].
When reflecting team members have the opportunity to actually interview each other about their comments and their questions, and are oriented in this by the narrative metaphor, then the outcome cannot be some disconnected series of superlatives, or a barrage of unrelated comments and questions - the work becomes thematic.
Very often therapists find the notion of reflecting team members interviewing each other a relatively new notion, and they can have difficulty in maintaining this during the course of the team response. This difficulty can be addressed by suggesting that one team member undertake to monitor the discussion and, if necessary, provide a prompt from time to time: ‘Look, I think that we are going off the track here. This work is meant to be structured along the line of a series of interviews.’
Throughout the reflecting team interaction, team members are careful to avoid the indicative, and instead frame their responses to each other in the subjunctive mood of ‘as if’, ‘maybe’, ‘possibly’, and so on. In this way, team members can avoid participating in the construction of settled certainties.
4. Deconstruction
There is always an unequal distribution of power in the therapeutic context, regardless of the steps that are taken by therapists to render the context of therapy more egalitarian. And as previously discussed, the potential for this unequal distribution of power to be disqualifying and objectifying of people is greater in team contexts. In view of this, it is important that steps be taken to counter possible toxic effects of this power imbalance, to reduce the potential for harm. One contribution to such steps is for reflecting team members to assist each other to deconstruct their responses. This can be achieved if team members invite each other to embody their comments with, or to situate their speech acts in, the history of their personal experience, interests, intentions, imagination, and so on. If reflecting team members take responsibility to deconstruct their comments and questions in this way, this does provide at least some safeguard against the sort of impositions of ‘truth’ that are the outcome of disembodied speech acts.
This deconstruction of the comments and questions of team members occurs more towards the end of the reflecting team response. It is not usually necessary for all of the team’s responses to be deconstructed, because when people experience a few instances of this, they begin to take all team members’ comments as situated and authoritative in terms of personal experience, but not in terms of claims to some privileged access to objective knowledge. Sometimes it is wise for team members to select for deconstruction those questions and comments that seemed most emphatic, or those that might have had the greatest potential to be read as advice or judgement.
Example 1
Team Member J: I’ve found this discussion really interesting, and I remember that we got into it following a question that you asked about how this couple had managed to arrive at this point. What got you curious about this in the first place?
Team Member K: As I said, I knew that it wasn’t very far back that this couple were at what we might call point A. Now it appeared to me that, although they hadn’t achieved what they wanted to achieve, they weren’t still at point A, but somewhere down the track, maybe at point D. So, I wanted to know the B and the C of it.
Team Member J: Yes, but what was your intention in drawing this out with Donna and John listening to this? What effect did you think that your comments would have on them?
Team Member K: I was thinking that when people take steps that are not all that visible to them, it is hard for them to take a leaf out of their own book with regard to future steps. So I figured that if these steps were more visible to John and Donna, they could look back at them, and that this would give them more of a sense of the path that they are on, and that this would help them to know more about where to place their next steps.
Example 2
Team Member L: I’d like to go back a way to ask you about why you assumed that this development was so important?
Team Member M: It seemed so obvious to me, and it sure seemed significant to the rest of the team.
Team Member L: Yes, I agree that it did. But of all the people in the team, why were you the first to pick up on this? Was this something to do with their personal experiences of life, or something else?
Team Member M: I don’t know if I actually thought about this. But, as we are talking, I am aware of the fact that, when I was Sue’s age, I was going through some of the same things that she is going through with her parents. And somehow we all got through it, but I never really figured out how - at least not completely. I was aware of my mother’s contribution to resolving things, but now I am thinking that my father may have played some part in working this out as well. So I am going away with some questions to ask him that I didn’t have before this interview.
Example 3
Team Member N: You have responded quite enthusiastically to the efforts that Alexandria has been putting into her relationship with her daughter. I would like to know where you were coming from in your comments.
Team Member O: Your question has caught me off-guard. I’d like to reflect on it some, so could I pass on this for the time being, and perhaps come back to it closer to the end of our discussion after I’ve had more time to think on it?
Team Member N: Okay. That’s fine.
Team Member N: (some time later) We have nearly run out of time, and I’ve been wondering whether you’ve had any thoughts about that question?
Team Member O: You know, I have. When my daughter was the same age as Christine, many years ago, I had the same concerns about her that Alexandria has about Christine. And I felt quite inadequate in my attempts to address these concerns, and have always felt that I let her down somewhat. But getting in touch with all of the efforts that Alexandria has put into getting this right, and the fact that she is also a sole parent, has helped me to appreciate what I was up against in getting things right, and all of the effort that went into this. So this interview has been very important to me for many reasons.
When team members take some responsibility to deconstruct their comments and questions in this way, this has the effect of countering the objectification and the marginalisation of those people who seek therapy. As well, the transparency that is the outcome of this is authenticating of the team members’ contributions - their interest and their curiosity are not experienced by people as academic. Also, as this embodiment of the responses of the reflecting team members counters the possibility that their ‘truths’ might be imposed on people’s lives, it provides for a more egalitarian therapeutic context.
In regard to the practice of situating one’s comments and curiosity within the context of one’s personal experience, team members take care not to engage in the expression of their experience for the sake of the expression of their experience and, in so doing, also take care not to provide a ‘moral story’ or ‘homily’ (which is unlikely to happen if team members have entered the conversation through the route of curiosity).
This sharing of personal experience is not ‘indulgent’ in its form. It is clearly not in the tradition of the ‘bare-it-all’ approaches; it is not about team members expressing all of their distressing and difficult experiences with people who seek consultation. This sharing of personal experience is not done with the goal of smuggling in ‘Here, take a leaf out of my book’. It is not undertaken to give people the sense that the team member concerned has arrived somewhere in life. And it is not gratuitous. But this sharing of experience is purposeful, and undertaken in cognisance of, and in a way that it is honouring of, the therapeutic contract.
Team members do not meet together before the second interview to prepare their comments and questions. And as their interaction evolves across the second interview, they often find themselves talking about what they would not have imagined they would be talking about ahead of their reflections. At times, team members find themselves contemplating previously forgotten or half-forgotten memories, and filling gaps in the primary narrative of their own lives. At times, team members find themselves talking about or thinking about their own lives in different ways, ways that contribute to an entirely new appreciation of some of the events of their lives. And, at times, team members have vivid experiences of some of the alternative stories of their lives, ones that bring new options for action. Whatever the case, this reflecting teamwork is shaping of the lives of team members. They emerge from this work with their lives remade. In various ways, they have become other than who they were before their participation in the reflecting team. Needless to say, team members are unlikely to find this work tedious, but invigorating.
Third Interview
In the third part of the meeting, everybody switches place again, as the people who sought the consultation are interviewed about their responses to it, with the team members taking their place as an audience to this conversation. This interview first focuses on people’s experiences of the second interview - that is, the reflecting team discussion - and then on their experiences of the first interview. At this time, the interviewer also shares his/her responses to the reflecting team’s comments, his/her thoughts about what s/he would be interested in taking up at the next meeting, and solicits the people’s responses to this.
People can be asked to give feedback about those comments and questions which particularly caught their attention, or which seemed helpful, and to distinguish these from those that didn’t seem relevant or that were unhelpful. They can then be interviewed about those comments and questions that were significant to them, on the understanding that the interviewer and the team members can’t know in advance what will be most helpful in this work, and that what is learned from this interview will be relied upon to guide the work itself.
This is also the time at which the interviewer can ask future-oriented questions that open up space for the exploration of possibilities for action. For example, the feedback that the interviewer receives at this point may suggest that one of the reflecting team comments was particularly significant in that it brought with it an important realisation. In response to this, people can be interviewed about what they predict to be the effects of this realisation. How might this shape their responses to the sort of events for which they sought consultation? What might help them to keep this realisation close at hand over the forthcoming weeks?
Fourth Interview
In the fourth part of the meeting, everybody gets together - the interviewer, the people who sought the consultation, and the team members. At this time, it is the process of the interview itself, and its deconstruction, that is the focus of discussion. Usually (although not necessarily), at the outset of the fourth interview, the interviewer is interviewed by team members about the specifics of his/her participation - for example, about why s/he asked certain questions and not other questions, about what these questions were in response to, about other questions that s/he might have liked to have asked, about what s/he was thinking about at particular points during the meeting, and about how this informed his/her comments at this time, about what his/her intentions were in regard to certain responses over the course of the interview, about the sort of personal experiences that might have been influential in determining these responses, and so on.
The interviewer can then reciprocate by interviewing team members about their thoughts on some of the possibilities that might have been more fully explored during the meeting, the line of questioning that they believe may have assisted this exploration, their proposals for following up what they believe important to follow up at the next interview, their predictions about the possible outcome of doing so, and so on. At this time, the interviewer can also interview team members about some of their team reflections.
As this fourth interview develops, team members are free to interview other team members about these matters, and the people who have sought the consultation are also invited to join in this. Because of the prevailing cultural construction of therapy, and because of the power differential implicit in this work, it is initially difficult for people to accept these invitations to join with the interviewer and the team in this way, but after one or two experiences they become more active in the formulation of questions.
There is the option for the interviewer and team members to invite those people who sought the consultation to comment on their experience of specific comments, questions, and any other events that occurred at any time during the three interviews. And, as well, team members can solicit people’s feedback about the structure of the work itself. It is important that the therapist and the team members avoid loaded questions that are in any way judging of each other’s contribution. And it is important that this fourth interview not just become an interview of family members because, should this eventuate, the opportunity for deconstruction of the therapy itself would be lost.
The interviewing that constitutes the fourth part of the meeting provides, among other things, an opportunity for those people seeking consultation to ‘come behind the scenes and join in on the ground floor’ so that they might have access to the workings of the therapy. To achieve this, the interaction between the therapist and team members is structured according to the principle of transparency (see White 1991), and care must be taken to draw an adequate distinction between interaction around this principle, and around those principles which shape many of the team’s responses in the second interview. Being true to this principle will not be possible if team members use the fourth part of the meeting for the purposes of further reflections of a re-authoring nature. To achieve a participation that is guided by this principle of transparency requires a reorientation, and at times team members find that this poses a difficult transition to navigate. Because of this, it is sometimes desirable to assign to one team member the role of monitoring the discussion, so that they might, when necessary, call the attention of other team members to the priorities at hand.
At the end of this fourth interview, the people who sought the consultation are invited to have the last say - to inform interviewer and team members of those ideas which were of most interest, to give an indication of those lines of questioning that they believe hold the most promise, and to provide feedback about any speculation on the possibilities that might be taken up at the next session.
The feedback that people give about this fourth interview is invariably positive - they respond to this transparency with enthusiasm - and many find this to be very significantly ‘therapeutic’. These findings contradict an idea that is at large within the culture of psychotherapy - that if people know what we are up to in this work, then it won’t have its desired effect. In the case of the ideas and practices that I have been referring to in this paper, it is apparent that the more transparent we are about what we are up to, the more helpful it is to those who are seeking consultation.
EVALUATION
Quite some time ago, I undertook an informal evaluation of the sort of reflecting teamwork that is informed by the idea and the structures outlined in this paper. This was undertaken on a basis similar to that of David Epston’s study of the value of therapeutic documents which is reported on elsewhere in this collection - ‘How many sessions worth of good therapy is a good reflecting team discussion?’ The outcome of this evaluation was fascination - at an average of 4.7 sessions of good therapy, it was very close to David’s figure of 4.5 for therapeutic documents. Since this informal evaluation, there have been a number of significant developments in this reflecting teamwork, and I have a plan to undertake a more formal re-evaluation of this work in the near future.
My informal evaluation of this work was of the more structured approach to reflecting teamwork, in which, during the first three stages, the team members and the people seeking consultation were audiences to each other’s conversations, but not engaged directly in discussion with each other. I have explored other arrangements in this work, including unstructured discussions between the people seeking consultation and reflecting team members. When people have experienced both arrangements, their preference is invariably for the more structured approach. Upon enquiring about the basis of this preference, I received responses like:
* If you get into a discussion with the team, this has the effect of depriving you of the option of standing outside of your life and experiencing it from a different perspective.
* I found it more helpful to sit back from my life, and to be an audience to the team, rather than sitting in my life in direct discussion with the team.
* When I interacted with the team in the second part, I didn’t experience the same thing. It wasn’t as powerful, and I think that this was because I was so busy editing what people said, and at times censoring what they said.
* When it was my turn to listen to the team, I felt that I was somewhere else, not with the problem. I could see how I didn’t have to be with the problem. This didn’t happen the time when I was talking with the team. It’s not that I didn’t enjoy talking with the team, but it just wasn’t the same as listening to them.
* There is something that is so much more powerful about listening to a conversation about your life that is acknowledging and respectful of who you are.
CONCLUSION
I have discussed reflecting team practices that are isomorphic with the practices of what has come to be known as narrative therapy. I have no first-hand familiarity with other forms of reflecting teamwork, and so I am not in a position to compare and contrast the work that I have described here with other approaches. The reflecting team practices that I have detailed here provide people with a deep sense of acknowledgement and with opportunities to break with many aspects of their life as they know it. As well, it has become clear that teamwork of this sort provides for people something akin to a quantum leap in possibilities for the re-authoring of their lives, and in options for action in the world.
I believe that the ideas and practices of this work go some way towards (a) providing a check on the potential for the power imbalance, which is inherent in such contexts, to do harm, (b) assisting therapists to break from the discourses of pathology and from formal systems of analysis that are so marginalising and objectifying of people - in fact, I believe that these ideas and practices can play a part in undoing the effects of these experiences, (c) challenging the supremacy of expert knowledges, (d) privileging alternative knowledge systems, (e) providing some options to address the propensity of therapeutic contexts to reproduce many of the negative aspects of the structures and ideologies of the dominant culture. However, I am not satisfied that those developments in the reflecting teamwork that I have described here go far enough in all of this, and this provides me with the impetus to engage in further explorations of this work.
This account of reflecting teamwork does not exhaust the possibilities at any level. For example, to facilitate the deconstruction of the therapy itself in the fourth interview, the interviewer, the team members and the people who sought the consultation can sit down together and undertake a microanalysis of the selected videotaped segments of the first three interviews. Non-therapists can be prepared for participation in reflecting teamwork - that is, family members, other relatives, friends and acquaintances, peers, etc. - and there are many contexts in which this work might be introduced - in schools, in workplaces, at the special meetings of various communities, and so on. And there are options for creating reflecting team contexts when working solo or in isolation.
Here, at the conclusion of this paper, I would like to acknowledge my debt to Tom Andersen for originating reflecting teamwork. It was his conception of this work that stimulated my own explorations of it. To the reader, I wish you all well in your own explorations of reflecting teamwork. Perhaps some day we will cross paths and have the opportunity to swap notes on this.
REFERENCES
Andersen, T. 1987: ‘The reflecting team: Dialogue and meta-dialogue in clinical work.’ Family Process, 26:415-428.
Foucault, M. 1988: ‘The ethic of care for the self as a practice of freedom.’ In Bernauer, J. & Rasmussen, D. (eds), The Final Foucault. Cambridge: MIT Press.
Myerhoff, B. 1982: ‘Life history among the elderly: Performance, visibility and remembering.’ In Ruby, J. (ed), A Crack in the Mirror: Reflexive perspectives in anthropology. Philadelphia: University of Pennsylvania Press.
Myerhoff, B. 1986: ‘Life not death in Venice: Its second life.’ In Turner, V. & Bruner, E. (eds), The Anthropology of Experience. Chicago: University of Illinois Press.
White, M. 1991: ‘Deconstruction and therapy.’ Dulwich Centre Newsletter, No.3.
Copyright © 1995 by Dulwich Centre Publications
