Preface
Family therapy has taken several decisive steps since
the time of Salvador Minuchin. In his structural family therapy model the
assumption was that problems were signs of structural deviations in the
family. The assumption was that the problem was not the real problem but
was merely a symptom of a dysfunction in the family.
The brief therapists at Mental Research Institute (MRI)
on the American west coast didn’t agree with Minuchin. They couldn’t
care less about the structure and dynamics of families. They leaned on the
spirit of Milton Erickson and claimed that the problem was not at all a
symptom of intra-psychic conflicts or family problems, but was the result
of trying to solve a problem in the wrong way. They declared; "The
problem is not the problem, the attempted solution is the problem."
They rejected a professional culture where therapists spent innumerable
hours to diagnose, understand, interpret and think about individuals and
families. They thought that the focus should be on what people had tried
to do to solve their problem that hadn’t worked, to be able to suggest
that they should do something else instead.
This radical view made therapy briefer while it at the
same time confused other professionals. There was talk about paradoxes and
incredible anecdotes were told where therapy was starting to look like old
sagas where wise old men told their poor clients to do the weirdest things
to solve their problems.
But before a wider public had become acquainted with
the fascinating brief therapy a new change occurred. Steve de Shazer and
others working at Brief Family Therapy Center in Milwaukee, USA, started
writing about these new ideas that they called "solution focused"
instead of "problem focused".
The Milwaukee-group disagreed with the brief therapists
at MRI. They claimed that the problem was the way one had started to talk
about the problem. They had found a new way to talk to people. An
optimistic way that built on the future, progress and the clients own
resources. They had found a way that fit with the thinking of Milton
Erickson: "The patient knows the solution to his problem. Only he
doesn’t know that he knows." They transformed their ideas into a
relatively structured formula, a model that promised results as long as
therapists followed what the model dictated.
The group in Milwaukee wasn’t the only group to
become aware of the importance of language and story-telling in the
maintenance or disappearance of problem. On the other side of Earth,
Michael White and David Epston had started to write about more or less
similar ideas. Some of the people connected to Lynn Hoffman had started to
call themselves ‘Post-Milan’ and expressed that systemic therapy
needed to become more humble and respectful. Tom Andersen in Norway agreed
and contributed with his ideas about the ‘reflecting team’.
The Malmö-group has been brave. They had worked hard
to learn structural family therapy, but in spite of their sacrifices they
were prepared to set out on a new course when they became acquainted with
solution focused therapy. But they didn’t do as many others. They did
not become Scandinavian copies of Steve de Shazer, but started to develop
a style of their own. In the work that Harry Korman and Martin Söderquist
describes in this book, the scent of solution focused therapy is strongly
sensed but there are also many other appealing aromas in the soup.
It shows courage to start working with addicts. It
shows courage to work with such a radically new perspective as solution
focused therapy. It shows creativity to apply the model in a unique way
and finally, it shows generosity to have written this book.
Ben Furman
Helsingfors October, 1993.
When the understanding of a psychiatric syndrome allows
specific prevention (so that it deserves to be called disease), it is
habitually transferred to somatic medicine (syphilis, pernicious anemia,
Huntington etc.). It is an open question if the encounter between the
diagnostic syndromes of psychiatry and molecular-biology and the genetics
of the future will result in conditions that are well understood and will
remain within the realm of psychiatry. Good explanations to a how a
psychiatric condition arises doesn’t necessarily generate useful help.
Caring for people with psychotic conditions is therefor
not the only definition of the core of psychiatry; we could as well talk
about the art to help or the knowledge about how desperation is
transformed into vitality. Seen like this, the diagnostic and therapeutic
focus on the individual should be supplemented with a focus on the
interaction between individuals. Above all there is a need for good models
for treatment of the individual and her network of important persons.
A modern Anglo-Saxon model of this kind "Solution
focused brief therapy", is now introduced for the first time in
Swedish textbook format.
I am proud that the authors belong to the Child and
Adolescent Psychiatric Clinic of Malmö. As former "addiction-doctor"(?)
I am glad that the clinical experience behind the book is built on the
clinics program for hard core heroin addicts; "Family therapy with
heroin addicts".
The basic concept to brief solution focused therapy is
that everyone creates/recreates identity and life moment by moment, using
among other feed-back from ones surrounding.
The concept seems self-evident and incontrovertible,
even if concepts from the influential, but maybe irrelevant, digitalized
world could incite to contemplation.
The same is for the idea that we create meaning in our
life by choosing to remember actions/experiences into a fitting own "life-story",
integrated in us with the aid of feed-back from important other people.
That a redefined "life-story" creates the
possibilities for new actions/experiences follows logically from these
concepts. Focusing the content of interaction onto such definitions of
problems that facilitate solutions in the present and the future is
purposeful.
The value of the model and methodology presented here
should be tested empirically and developed clinically.
The experiences so-forth are promising. Try yourself!
Valle Rune
Doctor in Medicine, Chief of staff
Child and Adolescent Psychiatry, Malmö
We are amazed that we today use the same positively
connnoted words to describe our work as we did 10 years ago. The
differences in what we actually do are so big that it is enough to look at
a vide-tape for 5 minutes to see if it was recorded 10 years, 5 years or 1
year ago. But we still use the same words; respect, wholeness, humbleness,
faith in people’s resources, families are unique etc. The meanings of
these words have slowly changed. Because of this we have stopped believing
that adjectives can adequately describe what is unique about solution
focused work.
We believe that it is when therapists start
understanding the basic difference in perspective between working with
problems, and constructing solutions that they can realize the
possibilities inherent in this different perspective for Klas and Pernilla
and Lasse and other clients.
The joy and freedom that we felt in our work, and we’ve
seen other therapists find in theirs, has been one of the things that has
pushed us into writing this book.
Another thing has been the clients we have worked with.
We have seen that our sometimes unusual questions have helped them find
inventive and sometimes even strange solutions to problems that have
tormented them for years. We have seen that unusual questions lead to
unusal answers and we believe that many more therapists could ask unusual
questions.
We hope that this book can inspire therapists to see
their work and their clients in a new and different way. We hope that some
will find questions they haven’t asked before and therefore will get
answers they never heard before.
The way to describe our work and a large part of our
thinking is based on what we learnt from Steve de Shazer and Insoo Kim
Berg. Most of the concepts in the book are theirs and as we have chosen
not to burden the book with references it will not always be clear how
much we have to thank them for.
We want to thank:
Maria, Anna, Ronny, Bosse, Anders, Kristina and all the
others and your families who taught us respect for the strength and
courage it takes to win the fight for a life without drugs and alcohol.
Our colleagues from the Heroin-program: Peter Appel,
Lars Dannerup, Sonja Edvardson, Kristina Engman, Ing-Marie Hansson,
Jehoshua Kaufman, Holger Klintman, Jocelyne Lopez-Korman, Barbro Persson,
Valle Rune and Aviva Suskin-Holmquist,
Our supervisors and the people who inspired us: Insoo
Kim-Berg, Steve de Shazer, Olof Ulwan, Charles Fishman, Ben Furman, Peter
Lang, Ulf Korman, Tilman Furniss, Bernadette Christensen, Sissel Reichelt,
Ernst Salomon, Klas Grevelius, Marianne Cederblad, Geza Patkai.
Our colleagues at the Child and Adolescent Psychiatric
Clinic in Malmö, Sweden. |
