Salvador Minuchin and Richard Schwartz on Family Therapy in the Postmodern Age: A Brief Review of their Views

By Tom Smith, Ph.D.

 

In late 1998 an article by Salvador Minuchin entitled, “Where is the Family in Narrative Family Therapy” appeared in the Journal of Marital and Family Therapy. The grandfather of family therapy became concerned and almost alarmed at the influence of the Solution-focused and Postmodern approaches to therapy postulated by the well known Insoo Kim Berg and Karl Tomm, respectively, on the practice of family therapy. It seemed to Minuchin that these two therapists were asserting that family therapy does not require working with the family as a unit and that it is the individuals in the family and their problems and stories that really mattered.

As the preeminent and perhaps, wiser systemic family therapist, he began to question this approach and whether it was family therapy at all. Many therapists were embracing the new idea that society is at the root of the family’s problems and the solutions to these problems are to be found in culture and politics. Although there is certainly merit in the thesis that reality is socially constructed by the powers that be to perpetuate the status quo, Minuchin felt compelled to pose two fundamental questions: Can the social constructivism that is the philosophical heart of the Postmodern approach help family therapists better understand how families function; and does this theoretical shift suggest a new direction for family practice? No one else was critically questioning the solution focused, narrative approach.

To begin answering these questions, he turned to the social constructivists to get a clear idea of just what it is they are trying to say and he found that they understand reality to be an artifact of culture and society. A major focus of social constructivism is to uncover the ways in which individuals and groups participate in the creation of their perceived social reality. It involves looking at the ways social situations are created and institutionalized. Socially constructed reality is seen as an ongoing, dynamic process of storytelling over and over; reality is reproduced by people acting on their explanations for and knowledge of it. As more data is available, the story changes and grows into a life of its own. There is no objective social reality. We are making it up as we go along.

He realized that social constructivism is an ideology with little political punch that seemed to change little or nothing in the “oppressed” family. How, then, were these ideas affecting family therapists and the practice of family therapy?

In this framework, family therapy became politicized. To solve the family’s problems or resolve their issues one had to take a political stand against subjugating stories of race, socioeconomic status, gender, sexual orientation and so on. Minuchin still felt in a quandary: What does this have to do with family therapy? What about issues around maternal bonding, interpersonal transactions, conflict between parents and the effect on children, the dynamics of divorce, remarriage and blended families and patterns of relationship between family members? Can the Postmodern therapist work with the family as a social system or has the context of family evaporated entirely and been replaced by powerful social formulae broadcast to individuals. Where is the family in this type of therapy? Is it sufficient to simply be the audience to each other’s stories without observing the way family members interact with each other; that is, the context in which the story about themselves and the world develops? It seems the family has become invisible.

What is missed is that the individual develops from the inside out as well as the outside in. To dismiss the family and jump to the influence of the larger culture is to ignore the reality of significant others and our relationship to them.

So the answer to Minuchin’s first question, “Can the social constructivism that is the philosophical heart of the Postmodern approach help family therapists better understand how families function?”, appears to be “no”. He points out that in the last 40 years a great deal of research in various disciplines has expanded out knowledge of family function. The usefulness of social constructivism should be approached with a critical eye and one should not embrace the Postmodern approach just because it is in vogue or the “latest” trend in therapy.

Nevertheless, this theory does prescribe a particular type of family therapy that directs the therapist to avoid putting their personal framework of reality on the family. It suggests a more collaborative type of therapy that is directed by questions rather than assumptions about the family. But, even though this theoretical shift suggests a new direction for family practice, in Minuchin’s words, it is a focus that “decreases attention to the patterns of interaction presently played out by family members”. Those familiar with Minuchin and his approach will not be surprised by this conclusion.

So, Minuchin observes that there are therapists whose concern for the significance of culture and its influence and the high value they put on individual experience and the accompanying story overrides and marginalizes the importance of the whole family experience. The sociopolitical, cultural stance of the constructivists is probably politically correct, but “therapeutically questionable”. Even when telling of personal stories to identify the internalized voices of the “zeitgeist”, little effort is made to deal directly with family interactions.

Michael White, the narrative therapist “par excellence”, emphasizes the retelling of the story over and over again from the different members of the family to “thicken it up” as he puts it. Asking questions helps the individuals explore new meaning, but this seems more of a voyage of personal discovery for each family member than working with the family as a social unit. Although this approach may be stimulating and fulfilling to individuals it does not address how they get along with one another. Might the theory itself be oppressive by invoking rigid dictums or methods in the conduct of therapy. At this point, whether it is “family therapy” or not is again questionable.

Minuchin does admit that the Narrative therapists do bring something to the table of family therapy, but he also asks just what are they throwing away.

They challenge the emphasis on diagnosis and deficit with alternative meanings and multiple descriptions of the situation. They understand the power of the influence of the therapist and the collaborative possibilities in working with the family. Through precise and elegant questioning, they explore the language family members are using to “create their reality”. They work closely to identify the internal voices that define our experience.

But, in Minuchin’s words, “What are they shedding”? Just watching the conversation among family members can reveal its effect on interpersonal behavior. Who does what, when what is said? The structured questioning of the Narrative therapist excludes opportunities for spontaneous enactment and a live scenario where transactions are acted out. By staying removed from family interaction, the fruit of the therapist’s knowledge and influence cannot be shared and healthy interactions modeled. Finally, by not acknowledging that the therapist either consciously or unwittingly brings their own bias and perspective to the therapeutic interaction, the relationship becomes artificial and insincere. These are no small losses.

Minuchin concludes by observing that the Narrative method highlights culture at the expense of understanding the family system which is the root from which the culture springs. Thus, the method does “not fully reflect the reality of human experience”.

This heuristic critique of Narrative therapy by Minuchin had its effect. Only six months later Richard Schwartz, who himself had no minor part in the evolution of family therapy, picked up on Minuchin’s points by first acknowledging and welcoming the debate in an article entitled, “Narrative therapy expands and contracts family therapy’s horizons” in the same journal that Minuchin’s critique appeared. He felt Minuchin’s points were lost by people focusing only on the singular issue of whether it is “family therapy” if you only focus on one person.

Schwartz acknowledges that the historical focus on family pathology did no service to the family’s self-esteem and had negative consequences that Narrative therapy wanted to ameliorate by refocusing on the “problem” or the “story”. Moreover, therapists felt freed from being in a judgmental position by no longer having to diagnose a family system. Additionally, Narrative therapy enlightened the individual members of the unit to the oppressive cultural and social themes that, more often than not, influenced the family’s dysfunction and view of themselves; namely, racism, domestic violence, gender inequity, sexual abuse of children and the discrimination against the GLBT and other alternative family units. The Systemic therapists felt that these issues distracted everyone from the therapeutic process.

The family is no longer the problem; the problem is the problem. It is the narrative or story of the family that needed to change, not necessarily family hierarchy, boundaries or behavior. By changing the story the family becomes empowered in a seemingly powerless situation. Family interactions or intrapsychic issues are not the source of family distress (or pathology as the Systemic and Psychodynamic therapists would put it), but rather the “toxic effects of cultural narratives” that, without our awareness, direct and control our lives.

From this point of view, the therapist and family are liberated from having to talk about something wrong with anybody. Because of destructive cultural discourse, everyone has the problem in one form or another. Schwartz feels that this too easily lets us off the hook and permits us to ignore the very real fact that “Johnny steals things and beats up on people”. But, on the other hand, the Narrative approach compels each family members to confront their own participation in the sociocultural stereotypes that pertain to gender, race, class, economics, etc.. Problems are not inherent in individuals because you cannot remove the individual from the social, cultural, political context. Narrative therapy again tries to liberate us from induced narrow, self-defeating views of self and the world.

Two polar views have been established: Systemic family therapy ignores the power of the social, cultural and political discourse (or confabulation) and the Narrative method disregards family process.

The question remains: Why can we not have intrapsychic, systemic and narrative methods at our disposal to assist the family in its move toward health rather than the singular camps of Psychoanalysis blaming individuals, Family Systems rescuing individuals from and blaming families, and Narrative approaches rescuing families and individuals from and blaming society?

Schwartz asserts that to privilege any one way of focusing on the family is to constrain both the therapist and the family from reaching therapeutic goals. How we focus on the family is more important than the level of the focus taken. It is possible to use all the tools in the box, switching from one to another as the need arises. By focusing just on the sociocultural narrative, the therapist may miss interpersonal oppression within the family and by just looking at family dynamics, the impact of the family’s economic, racial, gender, geographical, etc. situation may be ignored (at the peril of the therapist not getting paid).

Family members do hurt one another. Criminal behavior can be rooted in the family violence of deranged individuals, as well as the political and economic situation within which the family must participate. Addictions are the result of both the availability of alcohol and drugs in the society and the pain within the individuals and family as a whole that they are attempting to medicate. Some parents want to sabotage the growth of their children and some children want to take revenge on their parents. Telling that story over and over again to “thicken it up” may well exacerbate the problem.

Finally, Schwartz tries to bring some balance to the debate by suggesting just that: Balance; balance in our approach to bringing the family to health and even better, optimum performance and relationship. We therapists are called to use all the tools in our kit bag. Nothing is taboo if it works. There is no need to inexorably go down one therapeutic path at the expense of another more fruitful direction.

References

Berger, P. L., Luckman, T. (1967). The Social Construction of Reality: A Treatise in the Sociology of Knowledge. Anchor Books.

Minuchin, S. (1998). Where is the family in narrative family therapy?. Journal of Marital and Family Therapy, 24(4), 387-404, October, 1998.

Nichols, M., & Schwartz, R. (1991, 1995, 1998). Family therapy concepts and methods: 2nd, 3rd, and 4th editions. Cambridge, MA: Allyn and Bacon.

Pinker, S. (2002). The Blank Slate: The Modern Denial of Human Nature. Penguin Books.

Schwartz, R. (1999). Narrative therapy expands and contracts family therapy’s horizons. Journal of Marital and Family Therapy, April, 1999.

White, M. (1989). Selected papers. Adelaide, Australia: Dulwich Centre Publications.