Positions and Polarities in Contemporary Systemic Practice

The Legacy of David Campbell

Sara Barratt, Charlotte Burck, Ellie Kavner, Sara Barratt, Charlotte Burck, Ellie Kavner

• Publisher: Routledge
• Year: 2018
• Topic: Psychology
• eBook ISBN:
  9780429917417
• Subtopic: Education in Psychology
• Index: Psychology

This book provides a rich collection of the work that has been informed by the ideas of the eminent family therapist and clinical psychologist, Dr David Campbell who died in August 2009. Contributors are drawn from different fields and describe models they have developed for organizational consultation, training, therapy and research. The book includes a range of important topics, key ideas which thread through contemporary theoretical frameworks, a research study into young people's experience of parental mental illness, and the application of Dr Campbell's use of semantic polarity theory in supervision, research and clinical practice. The innovative consultancy model developed by David Campbell with Marianne Groenbaek is elaborated here. Personal accounts of work in different contexts include a priest consulting within his community, the use of self in training systemic psychotherapists, the experience of consultation in academic settings, and a narrative of a training course for psychiatrists. Interspersed with these chapters are David Campbell's own reflections concerning the development of his ideas and practice over time.

PART I

THERAPY AND THEORY

CHAPTER ONE

Keeping cool in thinking and psychotherapy

Stephen Frosh

It is a great honour and pleasure to contribute to this volume for David Campbell, whom I knew for thirty years and who was one of the most significant influences on my thinking and therapeutic practice, supporting and supervising me in the limited clinical skills I have, and, latterly, helping me survive the exigencies of academic management through his careful and astute consultation. David’s unflappable interest, his personal courtesy and wisdom, and his capacity to think both individually and systemically—to stay neutral and curious, as systemic therapists say—penetrated to the core of what it means to be a colleague, a teacher, and a friend. In a Festschrift book such as this, with contributions from, and also an original audience of, colleagues and students of David, both being categories into which I fall, David’s capacity to generate relational warmth was obvious; so, too, is his immense intellectual contribution to the development of psychotherapy and systemic thinking.

The brief for this short chapter is to say something about my own work and the ways in which David’s ideas influenced or inspired this, rather than focus on David himself, but the two things are not that easy to prise apart. This is because among the large number of different ways in which David’s influence operates, the most pervasive is something relatively intangible, related to, but not dependent on, his teaching or writing. This, of course, is not to underestimate the significance of the content of David’s work. His promotion and development of systemic thinking, and particularly of the Milan model, was crucial for the flowering of theory, practice, and research in the area, and his many, mainly jointly authored, books and articles (for me, perhaps seminally, the chapter in Volume II of Gurman and Kniskern’s Handbook of Family Therapy (Campbell, Draper, & Crutchley, 1991)) remain primary source material for anyone wanting to learn this approach. Most of my own understanding of systemic theory and practice has come from this particular stable, with David at the heart of it. Incidentally, or maybe centrally, the collaborative nature of David’s writing is an important comment on the ethics of his work and its consistency. Wedded to the ideas of openness to discovery, relationality, contextualism, democratisation of expert processes, and collegiality, David rarely “sole authored” his writings. Rather, things were worked out dialogically, in and among people, and often—in his workshops and teaching—this process, with all its necessary hesitancy, was made publicly available for us all to learn from.

In my own writing, despite being too impatient and probably narcissistic to work very successfully with others, I have also been drawn to this democratic principle, although I am probably less sanguine than David and many systemic workers about the means through which it can be achieved. In particular, it has fuelled my critique of a certain kind of theorising which always finds what it seeks, because its concepts are imposed as a grid on whatever it comes up against, in a claustrophobically “top-down” way. This is reflected, for example, in some psychoanalytically inflected research that before it sets out to collect data already knows that it will find among its research participants a certain kind of wish, a defence against it, and an interpretation that can explain the links. I have argued recently that this kind of use of theory is itself defensive, missing the opportunities that an open engagement with material can give for the production of surprise; in my own sphere of work, psychosocial studies, this risks producing a new orthodoxy just when what is needed is something disruptive and uncertain (Frosh & Baraitser, 2008). How does one maintain this necessary uncertainty, particularly in situations of high pressure, in which, as clinicians or researchers, one might be required to provide answers: for example, to respond quickly to the demands placed upon one by patients, referrers, or funding bodies? The standard and important Kleinian-inflected Tavistock response to this is that it is managed through clinging on to the capacity to live in doubt, the cultivation of Keats’ famous “negative capability”, “that is, when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason” (in a letter to George and Thomas Keats dated 21 December 1817, Gittings, 2002, pp. 41–42). I like, however, to relate to this slightly differently, through the oppositions outlined by Jacques Lacan in his theory of the “four discourses” (Lacan, 1991). Without going into too much detail, it is worth noting, among the contrasts here, the relationships to knowledge embedded in the “discourse of the Hysteric”, the “discourse of the Master” and the “discourse of the Analyst”. The fourth discourse, that of the University, is returned to below. The first of them incessantly asks questions, pushing for the truth. The second tries to answer these questions from a position of knowledge. The third, the discourse of the Analyst, is a mode of stepping aside, a kind of judo in which the question is returned to itself, and in which the subject of that question—the one from whom it originates—discovers that no one can claim possession of the truth, and, hence, that a certain kind of freedom exists. Uncertainty here becomes a mode of truthfulness. This is not an easy stance to take, in therapy or in pedagogy, because those who come to us do so wanting answers, investing in our knowledge, and seeing themselves as having a right to gain access to it. In this sense, the discourse of the Master is a “lure”, attracting the unwary, but, rather than being seen as a way of responding adequately to people’s needs (as opposed to their demands), it can better be thought of as a way of propping up one’s own claims to expertise.

Despite its very different language, I think the systemic approach works along similar lines, trying to hold off from knowing too much too soon, enacting the uncertainty that should come with claims to understanding, and constantly iterating the importance of context in determining meaning. Circular questions, paradox, reflecting teams, conversational stances, curiosity: the lexicon of systemic technical terms and practices over the past thirty years references an impulse towards the democratisation of therapy in which the therapist tries to step aside from a position of power, even in the face of resistance on the part of clients. One of my PhD students, John Stancombe, showed convincingly in his thesis that the “neutrality” of family therapists was often interpreted by family members as a failure to listen properly. Because their particular positions were not endorsed, they were felt to be neglected or rejected. The strong impulse here, fuelled at times by an engagement with sophisticated contemporary theories of power (for instance, Michael White’s use of Foucauldian theory (White & Epston, 1990)), is to make the therapist and the patient partners, to equalise their position in a kind of Habermasian exchange of full rationality. That is, one should speak clearly and honestly, drawing the patient into a dialogue based on open principles of exchange, modelling thoughtfulness and non-defensiveness, and so allow a new narrative of experience to emerge. Interestingly, the relational “turn” in psychoanalysis says something similar, with important writers such as Benjamin (2004) building a notion of “thirdness” that emphasises intersubjective exchange rather than expert knowledge. My own view of it, however, is that dialogic attempts to unpick fantasies of expertise run up against both the realities of power and the intense desiring pull of the Imaginary—the wish, that is, for a master who can answer the call of the subject’s distress. The discourse of the Master needs quite radical disruption if it is to be undone, and it is difficult to do that in a context in which training regimes, academic and professional accreditation and social expectations promote the bureaucratisation of therapy and its reduction from being an ethical encounter to a technology of “treatment”. The tricks of the systemic trade are genuinely helpful here, ranging from active processes of selfdisclosure to the potentially collaborative engagement of clients with therapists’ thinking through techniques such as the “reflecting team”; but the institutional context in which this takes place militates against true openness and continues to reinforce an imaginary take on therapy as an “answer”, which is bound to fail. This references the other “discourse” of Lacanian theory, that of the University (Lacan, 1991), in which knowledge is flattened and bureaucratised. Knowledge loses its capacity to radicalise; it becomes a passage to gaining credentials rather than a way of pursuing truth. As Lacan said to the students after 1968, in a phrase that seems increasingly prescient in the context of the consumer movement within universities, “You come here to gain credit points for yourself. You leave here stamped, ‘credit points’” (Lacan, 1991, p. 201). In the psychotherapies, too, the movement, now very widespread, to accredit trainings with academic degrees has many virtues, but it does raise the spectre of making one believe that a human act of encounter can be reduced to a set of qualifications. What qualifies one to be a psychoanalyst is one of the major fault lines of the Lacanian movement (see Frosh, 2009a).

One can say against this that at least people who come to the institution in which David worked, the Tavistock Clinic, to be seen by members of the systemic team, are “recognised” in the sense of being treated with respect, just as, I believe, are all clients who come to the Tavistock, with its commitment to relational therapy of the psychoanalytic as well as systemic variety. As R. D. Laing once said, treatment is understood to signify “how we treat people”, how we engage with them ethically, and the spirit in which this is done is one in which thoughtfulness predominates over a rush to action and away from the reality of people’s pain. Yet, all institutions have their bureaucratising forces, and resisting this in order to open out our procedures in a way that challenges and interferes with the system is a problem for all of us.

However, back to the task. When I wrote that the most pervasive aspect of David’s influence on my work is also intangible, I was thinking not so much of his writing and teaching, but of what I think of, with great affection, as his style. For someone who generated so much warmth, he was remarkably cool. I mean some pretty obvious things by this, in terms of David’s balance and neutrality, his capacity to question and not to be thrown, his adoption of a certain mode of deliberate slowness that ensures that no rushing takes place, that time to consider is built into every response. Therapy with David was done in a kind of slow motion, in which what would spread around any system he joined was a new respect for language and for what Rose (2007), in a very different context, rather beautifully calls an “interval of reflection”, which she sees as the central requirement of an ethical stance. This interval is technically between “impulse and act”, as the moment in which identification and thoughtfulness can occur, in which it becomes possible to imagine a position outside one’s own, again a familiar impulse in systemic work. It is also a deliberate act of pausing, a mode of hesitancy that does not lead to a fully formed final statement, but is, rather, an uncertainty to be treasured against the pressure to instantly articulate a response.

What I want to trace here is how these attributes appear in a certain kind of relationship to psychotherapy that I like to think of as “austere”; that is, as difficult and rather relentless, because it refuses to get taken up with the emotionality of the moment of encounter. One of the criticisms that might be levelled against systemic family therapy is that it is too “cognitive”, in the sense of being concerned primarily with what people think and with the stories they tell about themselves and their predicaments, rather than paying sufficient dues to emotionality and the affective underpinnings of psychotherapy. This links with the kind of reflexivity that distinguishes systemic from psychoanalytic approaches. In the former, the issue is primarily one of externalising the impact of the therapist on the system which she or he joins, and deploying that impact in such a way that the system can be helped to reorientate itself productively. Classically, if one can speak that way about so new an approach, the observing team allows the reflexive impact of the therapist to be brought out into the open, making it amenable as a technique, making the system that is the “original system plus therapist” observable by the system that is the “team plus therapist” in one of those Venn diagrams with which systemic writers like to play. Reflexivity here involves moving outwards from the original system to dramatise the context in which it operates; as the therapist system and client system reflect on the difference they make to each other, so the adaptive propensities of each system can be explored. The psychoanalytic take on this is usually somewhat different, particularly in the Kleinian and object relations traditions and in the new modes of intersubjective and relational psychoanalysis that are increasingly influential around the world. Here, reflexivity refers to the intertwining of subjectivities, as unconscious material from each protagonist in an analytic encounter is passed to and fro, sometimes thought of as entering a space of the “third” for contact and amelioration, but, in any case, reflecting an affective element in the analyst as well as in the patient. The contextualisation here is of something that flows through the participants in the exchange and is felt by both of them, perhaps as a movement of excitement or injury. It involves the analyst considering the impact she or he is making on the patient and taking responsibility for that as a way of authorising the patient to move on (Benjamin, 2009).

Both these conceptualisations are powerful, and drawing them together has been one strand of work in which I have been tangentially involved (Frosh, 2009b). Both of them imply a significant level of affective engagement between therapist and client, so when I refer to “coolness” I do not mean coldness. But what both of them also insist upon is the requirement to maintain a capacity not to be drawn in by the seductiveness of the other; they are both suspicious of what can happen when one gets too close. That is, the sophisticated understanding of reflexivity present in both systemic thinking and in psychoanalysis acts as a protection against “acting into” the relationship, against, that is, trying to be too ameliorative, too helpful, even, perhaps, too therapeutic in one’s approach.

I am not against therapy, of course, but I am interested in a very old-fashioned distinction between an analytic process, the purpose of which is to examine phenomena through a procedure that elsewhere is called “deconstruction”, and a therapeutic process that tries to integrate and make things whole. Here, I frequently draw on a quotation from Laplanche that captures the difference between a perfectly legitimate and understandable impulse to make sense of things, and a more austere standing-aside that is less concerned with outcome and more with the sparking off of momentary truths. Laplanche writes, in a discussion about narrative, as follows:

The fact that we are confronted with a possibly ‘normal’ and in any case inevitable defence, that the narration must be correlated with the therapeutic aspect of the treatment, in no way changes the metapsychological understanding that sees in it the guarantee and seal of repression. That is to say, that the properly ‘analy...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• ACKNOWLEDGEMENT
• ABOUT THE EDITORS AND CONTRIBUTORS
• SERIES EDITORS’ FOREWORD
• INTRODUCTION
• Reflections on development of ideas: personal and contextual. David Campbell in interview with Charlotte Burck
• PART I: THERAPY AND THEORY
• PART II: SUPERVISION AND TRAINING
• PART III: RESEARCH
• PART IV: CONSULTATION
• INDEX