CHAPTER 1
PART I *
THE REFLECTING PROCESS
Opening Dialogues
Uttering a word it Jibe striking * note on the keyboard of the imagination.
—LuAung Wrttgtmttin
Tke ethical imperative: Act always to in create the number of choice*.
—Hmihx wit FtMTfitr
Adaptation cornea out of encounter, with novelty that may nam chaotic In trying to adapt, we may need to [behave] in way* we have barely glimpsed, Peking on fragmentary clues.
—Mary Catharine Bttitton
Reflecting Processes; Acts of Informing and Forming
YOU CAN BORROW MY BYES, BUT YOU MUST NOT TAKE THEM AWAY FROM ME!
Tom Antle
rsen
Concerning the psychology of the creative act itself, I have mentioned the following, interrelated aspects of it: the displacement of attention to tome thing not previously noted, which was irrelevant in the old and is relevant in the new context; the discovery of hidden analogies as a result of the former; the bringing into consciousness of tacit axioms and habits of thought which were implied in the code and taken for granted; the uncovering of what has always been there.
This leads to the paradox that the more original a discovery the more obvious it seems afterwards. The creative act is not an act of creation in the sense of the Old Testament. It does not create something out of nothing: it uncovers, selects, re-shuffles, combines, synthesizes already existing tacts, ideas, faculties, skills. The more familiar the parts, the more striking the new whole.
—Arthur Kotstter (1964, pp. 119-120)
My way op telling about the origin and development of the reflecting processes has shifted over the years. At first I often referred to theories, as if these processes were born out of intellectuality. Now I do not think so. I think they rather were consequences of feelings. Although I was unaware of it when the reflecting process first appeared in March 1985,1 now think it was a solution to my own feeling of discomfort as a therapist. Being a
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therapist is first of all being with others, and it is hard to be with others when they and I feel uncomfortable about that being together.
The rather personal start of this chapter might indicate its limited value for those who prefer objective descriptions. However, those who are attracted to the hermeneutk tradition and its assumptions about knowledge as context-bounded, time-bounded, and person-bounded will, I hope, find it of less limited value. I will first write a few words about the hermeneutk circle.
THE HERMENEUTIC CIRCLE
This concept has been discussed by two German philosophers, Martin Heidegger and Hans-Georg Gadamer (Wachthauser, 1986; Warnke, 1987). They said that what we come to understand is much determined by the life we already have lived.Thelife we already have lived has brought to us general assumptions of various kinds, that is, how human beings best can be understood.
Gadamer says that we arc inevitably prejudiced when we meet with a person we are to understand; we have started to understand the person even before we meet him/her. Gadamer used the word "prejudice" and Heidegger used the word "preunderstanding"fcr this. Some people assume (have brought with them the preunderstanding) that what a person says and does is generated from an "inner core" of the person.Those who meet another with that preunderstanding will look for the signs in the other's behavior that reflect and indicate the dynamics of the assumed inner core.
An alternative preunderstanding to that of an inner core is that the center of a person is outside the person—in the conversations and the language the person rakes part in. The other person will be best understood by concentrating on his/her conversations and language.
These are only two examples of several existing preunderstandings of human beings. When we try to understand another person (within the frames of our preunderstanding) we might see or hear something we have never seen and heard before.This new information might turn back upon and nuance or even change our preunderstanding. The preunderstanding: influence on the actual understanding and the actual understanding's turning back upon and influencing the preunderstanding have been called the hermeneutk circle.
Other Prejudices
The concept of preunderstanding applies not only to human beings but to all phenomena we are to understand (make meanings of),including
the reflecting processes, the writing about reflecting processes, or the readers reading about the reflecting processes.
My preunderstanding is that the reflecting processes are very different from my writings about them. These processes comprise much more than I am ever able to see or hear. The writing is therefore a simplified version and relates to what I (according to my prejudices) found useful to look at and listen to. What I heard and saw, when put into writing, is described in my metaphors and my language, and I can never take it for granted that the words of my writing create the same images and thoughts in the readers as they do in me.
What I will Dry to do in this chapter is to be in a language that is as close as possible to the everyday language of "ordinary" people. My prejudice is that readers will interpret within the frames of their prejudices, and such a chapter as this might offer a chance for readers to reflect upon their own work and their own preunderstandings.
A Nuance
The "aim" of this chapter is not only to describe the reflecting processes but also to describe the contexts in which they emerged and developed further. Because parts of those contexts are my own preunderstandings, I give space to elucidating how being part of various reflecting processes turned back upon, nuanced, and changed my prejudices and my being-in-the-world as therapist. The reflecting processes can be seen as herme-neutic circles.
NOTICING THE FEELINGS OF DISCOMFORT
This section discusses body and feelings and might be out of context for some. If it feels so, please leap to the preludes of the reflecting processes on page 16.
As a medical country doctor in the north of Norway, 1 learned about ordinary life and ordinary bodily complaints. Aches and pains and stiffness in the various parts of the body (neck, shoulders, lower back, etc.) were the most common complaints in general practice but "too ordinary" to be of interest in acidemia. The medical school I came from did not prepare us as doctors for how to deal with it, so we were left to our own wonderings. I was fortunate to meet with a Norwegian female physiotherapist, Gudrun 0vreberg, who introduced me to her teacher, Aadel Bulow-Hansen, another Norwegian female physiotherapist. They both let me see into a world I had not looked into before, Biilow-Hansen's work over the years taught her that breathing and movements
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are two crucial sides of life; our breathing influences our movements and our movements influence our breathing. There are two words in Norwegian for breathing: one the more physiological word, to breathe ("i puste"), and the other a more solemn, maybe even a sacred word, co spirit ("i inde"). When a person passes away, Norwegians most often say he/she spirited out. We also say that we spirit the air when we are up in the freshness of the mountains or in places similar to that. Being-in-the-world is being-in-breathing. All our expressions and all our spoken words come with the exhaling phase of breathing; our laughing lets go of our happy feelings; our weeping elicits sad feelings;our barking voices convey angry feelings, and so on. And alt the thoughts and feelings are brought to the fore during the exhaling part of breathing.
Our movements, sometimes nuanced and fine, sometimes rough and coarse, are part of the interplay between those muscles that stretch various parts of the body (e.g., the knee) and those that bend the parts. The stretchers in front of the knee and benders on the back side are opponents. When they both work, their work in common will balance the knee. We need them all, both stretchers and benders, to balance the various parts of the body when we walk, sit, get up, turn around, and so on.
Biilow-Hansen noticed that in difficult periods (e.g., when we are worried, angry, or sad and do not want to let others see), a person is brought out of balance in the sense that the benders increases their activity and the stretchers are constrained (by the benders) in their activity. The person as a whole tends to "creep together" and the body tends to be "closed." Readers have most probably seen those who cross their arms over the chest and lean forward, in an act of "closing" the body. In this closing act, the benders in front of the shoulders and upper arms, those in the back of the neck, those in the stomach, and those on the front of the hip take part.
Biilow-Hansen noticed that simultaneously with the stretchers being constrained the breathing was also constrained. She learned that if she was able to help a person stretch and open up the body something interesting happened. A spontaneous inhaling occurs when the body stretches, and with that inhaling there is a certain urge to continue the stretching, which stimulates more inhaling. This circle goes on until the chest is filled, and when the air passively leaves the lungs, some of the tension in all muscles (also in the benders) vanishes.
In this process of stretching and breathing and letting go of tension, the muscular balance of the body as a whole is changed. One can sometimes actually see die posture of the person changing.
Watching this work closely in order to write a book about it contributed to a certain knowledge "creeping under" my skin. While writing the book, between 1983 and 1986,1 slowly began to understand
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that how Biilow-Hansen worked determined what she could reach. And how she worked was fit relation to the other
One of the ways for her to make the other person stretch a part of the body was to let one of her hands clench a tense muscle (e.g., the calf muscle) so that the clench produced pain. Pain is followed by a spontaneous stretch (of the knee), which is followed by inhaling. When her hand was too soft she could not see any response in the others breathing. If her hand got a bit rougher, making more pain, she could see increased inhaling followed by a release of air during the exhaling part. If, however, her hand was too rough, causing too much pain or clenching too long, the other would inhale in a gasping manner and thereafter not let the air go but hold on it. Biilow-Hansen followed the process intensively by watching the other's breathing all the time. If her eyes saw that there was no increase of breathing, her hand worked harder, and if she saw that the breathing stopped because her hand was too rough, she let that clenching hand go immediately.
This taught me at least two things. First, it made Gregory Batesons ideas about change visible. Bateson saw change as a difference that occurred over time. He also thought that a difference does not come by itself but with another difference; for example, if the temperature falls, one puts on one's jacket. In a few words, Bateson (1972) made the famous statement: "A difference makes a difference" (p.453).Batesons statement and Biilow-Hansen s work taught me that there are three differences of which only one makes a difference. What is too usual docs not make a difference. What is too unusual also does not make a difference. What is appropriately unusual makes a difference. These nuances are widely applicable in many situations and under many circumstances, including conversations.
The other thing 1 learned from Biilow-Hansen was that she looked (and T assume she also heard and maybe even smelled) how the other responded to her hands before her hands continued to work. Applied to psychotherapy, it means that 1 have to wait and see how the other responds to what 1 say or do before I say or do the next thing. The next thing I say or do must be influenced by the others response to what I just said. I have to go slowly enough to be able to see and hear how it is for the other to be in the conversation. If it is too unusual, the other feels uncomfortable and lets me know through one or many signs. There arc many signs and I shall just briefly mention some examples that will remind readers of what they already know: talking less, looking down or away, conveying the feeling that it would be better to leave the conversation than to stay in it, and so on. We can see the other feeling uncomfortable.
We can also notice our own feelings of discomfort in moments when we push the other (s) into something too unusual for them. If we
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are aware, our bodies will tell us. For me this feeling appears behind the lower part of my breastbone. Some say they feel ic in the stomach, some behind the eyes, some in the forehead, some in the lower back, and so forth.
TWO PRELUDES
The idea of being appropriately unusual to the others brought a more calm atmosphere to the therapeutic conversations in which I took part. That idea was one of two preludes to the first reflecting team in March 1985, and I believe it influenced the next prelude, namely a new way of giving interventions.
Our team initially worked using the Milan approach; in 1984, however, a shift occurred in the way we intervened with the families. We started to say, "In addidon to what you saw, we saw this," and "In addition to what you cried to do you might try this (what we suggested)."
This was to underline that both what the families and what we had considered were of value. Previously we had a clear tendency to try find the correct interventions, and if the families disagreed with our interventions a dispute easily broke out: Either they or we were right. This shift from an earlier either—or stance to the new both—and stance made everything more "democratic,"
In hindsight it seems that these two preludes were significant preparation to let the idea of open talks (reflecting) happen. The idea about such open talks had emerged already in 1981, and I mentioned it to Aina Skorpen, with whom I worked at that time. However, our fears that we might talk in a hurtful way about the families in front of them restrained us from trying. When we finally began to use this mode we were surprised at how easy it was to talk without using nasty or hurtful words. Later it became evident that how we talk depends on the context in which we talk. If we choose to speak about the families without them present, we easily speak "professionally," in a detached manner. If we choose to speak about them in their presence, we naturally use everyday language and speak in a friendly manner.
REFLECTING TEAM
The idea of open talk lay dormant for four years before we began to use it in March 1985 (the team members were Magnus Hald.Eivind Eckhoff, Trygvc Nissen, and myself). The young therapist talked with a mother, father, and daughter about their sad family life. The mother, who had
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difficulties seeing a positive future, had been to the mental hospital several times (sometimes because she had tried to kill herself). The therapist was drawn into their hopelessness and could not find questions to elucidate an alternative future. The team members, who followed the talk from behind a one-way screen, called the therapist to our room and gave him our optimistic questions. He brought them back to the family, only to be drawn back to pessimism immediately.
We tried the same tactic three times, with the same pessimistic consequences. Then, after a short discussion behind the screen, we launched the idea to the family and the therapist that we might talk while they listened to us. Our fears made us hope they would not accept the offer, but they did.
In those rooms in which we worked there happened to be loudspeakers and microphones. Therefore, we turned on the light in our room and they dimmed it in their room. We turned on the microphone in our room and they turned off theirs; wc turned off our loudspeakers and they turned on theirs. And there we sat in the lit room:visible and unprotected. (We finally realized how the families with whom we previously met might have experienced these arrangements: frightening and exciting at the same time.)
At first we stumbled over our words; we wondered whether there were possibilities that the family, for various reasons, had not yet seen? Our speculations became more and more lively as we envisioned an optimistic future. When we turned back sound and light, the family was totally changed: They talked eagerly about what they might do in the future. They even laughed. My immediate thought was that this is very different and this gives me a good feeling.
It did not take long before we stopped the switching of sound and light. We instead swapped rooms. The therapist and the family talked in one room with the team listening to that talk from the room behind the one-way screen. Then there was a shift when the team walked over to the "talking room**as the therapist and the family walked to the "listening room." When the team was through with their talking, the rooms were swapped again, and the family commented on the team's talk from the "talking room." The therapist is always together with the family, always separated from the rest of the team.
TWO DESCRIPTIONS
It took some time before it was possible to describe our process. At first we described it with the word "heterarchy." Many have not heard that word before, but everybody has heard the opposite word: "hierarchy."
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Hierarchy governs from the cop and down, and hetenrchy governs through the other
Therefore, the feeling of relief in March 1985 was most probably related to leaving the hierarchical relationships of therapy and entering the heterarchical ones.More common words for a heterarchical relationship might be a "democratic relationship" an "even relationship," or a relationship with equally important contributor!.
Sometime later, another description came to mind, namely, that the reflecting team process comprises shifts between talking and listening. Talking to other(i) can be described as "outer talk," and while we listen to others talk we talk with ourselves in "inner talk," If we let a particular issue be passed from outer talks to inner talks back to outer talks, and so on, we might say that the issue is passed through the perspectives of various inner and outer talks. Dateson was very concerned with the significance of multiple perspectives: One might understand the same issue differently in the various perspectives, and when these different ways to understand are put together {as in this reflecting process), they might create new ideas about the issue in focus (Bateson, 1980).
DIFFERENT REFLECTING PROCESSES
Once we grasp the idea that the shifting between inner and outer talks is an important element, we might set up these processes in many ways in many different contexts. Here are some examples:
1. There could be a team in the next room behind a one-way screen, or we might use only one room with the team listening and talking from a corner.
2. A therapist without a team could have one colleague present to talk with during "reflecting" intervals.
3. If the therapist is alone without a team, he/she could speak with one member of the family [person X) while the others in the family listen. Then the therapist talks with these others while person X listens to that talk, and later turns to person X for comments and eventually further talk. In this case the family and the therapist become a reflecting team.
4. If the therapist is alone with one client, they might talk about an issue from the perspective of one who is not present (e.g., a mother). For example, the client is asked to talk about what she thought her mother would think (inner talk) and say (outer talk) about this or that. When the mothers thoughts have been
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presented, the client might be asked, "What are your thoughts about your mother's thoughts?" S. [fa workshop or conference consultation goes on in a large room with an audience listening to it, the whole audience might serve as a reflecting team.
The applied forms are infinite and I assume that the limiting element is our own inventiveness. These processes might also be applied in several contexts besides therapy. Here are some examples:
1. In supervision, the supervisee might talk with the supervisor while other supervisees listen to that talk. Then the other supervisees and the supervisor talk while the supervisee listens, whereafter the supervisee and supervisor talk.
2. Staff meetings could be organized so that one half of the staff talks about a certain issue while the second half listen, whereafter the second half talk while the first half listen, and thereafter back to the first half, and so on.
3. Management leaders might come together to discuss certain issues. The group could be divided into smaller groups. One group could start talking about one particular issue while the other groups listen. Thereafter the discussion is passed over to the next group, which talks for a while before the discussion is passed over to the next group, and so forth.
4. In qualitative research the researcher might talk with another, for example, about his "data" and his attempts to search for something in his data, either a specific category or something unknown or not yet "discovered." Others who listen to that talk can then talk about what they were thinking when they heard about the researcher's search and about the not yet known, before the researcher gives his/her comment on what he heard,
SOME GUIDELINES
I would be the first to warn about a particular practice of a reflecting process. The less planned the process the greater the possibility of letting the situation determine its form. It is important that those who take part in the process can say and do what feels natural and comfortable.
When 1 am the person who speaks with the family, I never take it for granted that there shall be a reflecting teams talk even when a team sits by ready to give it I always ask the family; "There have been some people listening to our talk. Would you like to listen to what they have been
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thinking or what will be the best for you? We could stop our talk here, or we can continue without the teams talk. What would be the best?"
If the team's reflections (speculations) are requested 1 usually say to the family: "When the team talks you might find it interesting to listen to them. However, it might happen that your thoughts go other places. If so, just let it happen since you do not have to listen to the team. Or maybe you would rather rest and not listen or think so much. Or maybe you would like to do something eke. Do what you feel comfortable with."
I would never tell another team member how he/she should be as part of a reflecting teams talk. However, I have three guidelines for myself. The first is to talk (speculate) from something I saw or heard in the family's talk with the therapist. I usually start by referring to what I heard or saw: "When the mother said that she still thinks much about her father who just died, I could see her husband discreetly nodding in agreement, and I could see the children listening carefully to their mother even though they did not look at her." Then I try to talk in a questioning manner; for example, "I wonder if talking or thinking of htm is easy for all of them or if it stilt is painful for some? If it is still difficult for some to talk about him, what could they do so that those who want to talk about him have that possibility and those who are not yet ready for it do not need to take part in those talks?"
Statements, opinions, or meanings are avoided. Meanings can very easily be heard by the family members as something they should consider or even do, and if the team's meaning is different from their own, they might easily fee) it as "better" and their own second best. If that happens some families might even feel criticized.
If 1 am on a team when one of the other team members comes up with a strong meaning (e.g., "I absolutely think the father should do this or that"), 1 might ask that person: "What did you see or hear in the talk [the family had with the therapist] that made you come up with that opinion?" That allows the possibility of discussing what was heard or seen. If that which was seen and heard was discussed, other opinions might be hunched in addition to the first one. If the other sticks to his/her opinion, we might discuss how that opinion fit in the various family members' perspectives: "What do you think the father himself thinks of that opinion? What would the mother think of it? The father's brother?" These few exchanges might remind everybody about what they already know, namely, (1) if one saw or heard something else one might come up with another opinion, and (2) an opinion shifts its meaning according to the context (perspective) it is part of.
The second guideline is that I feel free to comment on all I hear but not on all I see. If a person in the family tries to cover something,
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for example, the mother clenches her teeth in order not to let the others see how sad she is, or the father tries to hide his angry feelings, which might be seen in his clenching fists, 1 never comment on that. I often remind myself about the talk between Zeus and Hermes, when Hermes took the post as a messenger god (to pass further the messages): Hermes promised Zeus not to lie,but he did not promise to tell the whole truth. Zeus understood. Mothers, fathers, and others should have the right to not talk about all they think and feel.
I use my third guideline when both the family talk and the team talk occur in the same room. I usually say to the team (with the family listening), particularly when there are members on the team who have never been in such open talks before: "I shall not instruct you or myself, but I have collected some experiences over time that 1 would like to share. When you are to talk I would recommend that you talk with each other and not include the family in your talk. If you include them in your talk, either by talking with them or by looking at them, then you force them to listen to you. and they cannot let their mind go other places if that is what they prefer [and I think: If that is impossible it is impossible, so let it happen]."
FOUR QUESTIONS
Four questions emerged from these processes. One is raised only to myself in my inner dialogue, two always in the open, and one sometimes in the open and sometimes only to myself.
The first one is constantly repeated to myself: "Is what is going on now appropriately unusual or is it too unusual?" If there are signs that tell me that it is too unusual, I have to change, either by talking about something else or by talking in another manner.
The second and third questions are tied together and they are usually asked in the beginning of a session and seem particularly important in the first meeting. The second question is about the history of coming here today. Who had the idea? How did the various others respond to the idea? Were all in favor of it, or were some reserved? The idea is for me to learn which of those who are present would like to talk and to learn whether any of those present would not like to talk. That helps me to be sure that I talk with those who want to talk and do not talk with those who do not want to talk. The third question is simply to ask all present how they would like to use the meeting. Everybody is invited to give an answer.Those who were reserved about coming to the meeting often have no answer, but those who wanted to come usually have one. This question is the most open I have found thus far. It allows for very
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different answers: "1 want to discuss my life philosophy," or," [ understand that t cannot proceed without making a point,and I would like to discuss how that might happen," or, "I am so tired and so exhausted that I want to just sit here and rest without thinking or talking."
It is most important in responding to the answer to the question ("How would you like to use this meeting?") that I talk about what they would ltke to talk about, and that I do not talk about what they would not like to talk about.
I might ask the fourth question if I feel that a new issue that is raised creates a certain tension. We must not take it for granted that everybody can talk about everything every way at any tíme. Therefore,this question, either raised in the open or only to myself, might be of value: "Who might/can/ought to talk with whom about which issue in which way at which point in time?" It might be that the original group is better divided into smaller talking units. This is to ensure that those who want to talk about the issue will have a chance to do so and that those who at the moment arc not prepared for it are excused from (hat talk.
THE PROBLEM-CREATED SYSTEM
Harold Goolishian and Harlene Anderson launched the concept of the problem-created system (Anderson Bi Goolishian, 1988; Anderson, Goolishian, 8c Winderman, 1988). They saw that a person with a problem often attracts attention from many other persons. These others might be family members,friends,neighbors, colleagues, official persons,and even therapists.
These others create a whole system of meanings about how the problem can be understood and how it can be solved. If these meanings are appropriately different, the talks between those who hold the meanings may create new and even more useful meanings, if the meanings are too different, the talks between those who hold the meanings will easily close down,
Goolishian and Anderson say that the big problem arises when the conversations stop When a therapist enters such a scene, already full of meanings, he/she should be careful about bringing more meanings. It is safer to ask questions and be interested in the meanings that are already there. If the therapist connects in a friendly way with the persons in the meaning system, these persons will more easily put their meanings into conversation. Maybe such conversations might loosen up and even change the various meanings so that the stalled conversations can start again.
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GOING TO THE MEANING SYSTEM
When a local therapist wants my assistance, I go to the therapist and work together with him/her and the client(s) in the therapist's office. The therapist and 1 can be a reflecting team during the meeting.The therapist and the clients determine whether I shall continue working with them, but very often one meeting is enough for them to continue the work without me.
FOLLOWING THE OTHERS
Those family members who want to speak talk as long as necessary. It feels intuitively right that clients should be given the time they need in order to tell me what they want me to know. That means that I, as the listener, must be cautious not to interrupt. It is interesting to follow the monologues of the various clients, as the undisturbed monologue seems to comprise shifts between inner and outer conversations.The inner talks occur when the client stops talking (to the other) and makes a "pause." This is, however, not a really pause; the client just "withdraws" or "moves to an other place"or "meets someone else" We can see that when his/her eyes move away and look somewhere else. I imagine that the client searches through all the "pauses" or stops and "rests" at something somewhere (i.e., searches for meaning^]). Then, after the pause, the eyes turn back to the othcr(i) present and the outer talk can continue.
The talk therefore comprises something that can be seen in addition to what is said and can be heard. These shifts between outer and inner talks are most meaningful if there are other(s) there to see and hear. Peggy Penn and Marilyn Frankfurt (1994) call the other(s)' contribution "witnessing." (See also Lev Vygotsky's [1988] discussion of so-called ego-centric talks.)
To Hesr Is Also to See
Not only the pauses can be seen but also the "openings" that we, the professionals, might take as the points of departure for our questions. I used to think that the questions more or less were intuitively chosen. Now I do not think so; the person who listens, besides listening to all the spoken, also tees how this is uttered. There are the small shifts in the way to utter that might make one think: "What 1 just heard, which was followed with what I saw, seems to be meaningful for her. It might be worthwhile to talk more about that"
These small shifts can be so many;a look in the eyes; the head drops;
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a cough; moving on the chair; the hands folded on the neck; one hand searching for something in the other hand without finding it; and so on.
These moves seem to occur when the person, while saying some words, hears the words as particularly meaningful; that is, the person's own word(s) move him/her. And the verb "to move" has in all languages two meanings: a physical and an emotional aspect.
New Questions
[ often notice that the person who is given the opportunity to talk undisturbed quite often stops and starts over again, as if the first attempt was not good enough. The client searches for the best way to express him/herself; the best words to tell what he/she wants to tell, the best rhythm, the best tempo, and so on. The expressions that come (of which the words are a part) and the simultaneous activity (the way the words are expressed) have attracted my interest. Therefore, it has been natural to disc usj not only the utterances themselves but also the way they arc uttered. One of the questions that has emerged is: "I noticed that you said this or that. If you were to search for something more in that word, what might you find?" For example,one woman said that independence was the big word in her family. Not only did she repeat the word "independence," but she said it with such a look on her face that it was natural to let it be a starting point for the next question: "If you were to look into that word, what might you sec?" She: "I don't like chat word very much." "What is it you don't like when you look into the word?" Crying, and with her hands covering her face, she said "For me to talk about loneliness is so hard . . . yes it means staying alone.. . ."
Another example is of a young father who had left his wife and 7-year-old son. Some rime after this happened he said that both he and his son often felt sad. When he said "sad,"there was an audible and visible sigh, and he was asked, "When your son is sad, is his sadness totally filled with sadness or are there other feelings in his sadness?" The father, who said there was also anger in his son's sadness, was asked, "If your son's anger could speak, what would the words be?" He said, "Why did you leave me? You said I was the most important person for you. Why did you leave me?"
To give another example, a man spoke about the relationship between him and his wife in such a way that in the middle of fear and uncertainty, war (or anger) broke out. He was asked, "Is the fear in the anger or is the anger in the fear?"He sat long, bewildered,and thoughtful before he could answer. This question remained with him all the time for three months.
A fourth example is a question that was related to a man who in
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fierce anger and without words hit another with his fist. The question was: "If the fist, as it moved toward the person it was to hit, could speak, what might the words be?" There were several answers: "I feel stupid" "I am not listened to." "Nobody understood that I was hurt."
A finally, a woman spoke about peace and when asked said that "peace"was a very big word for her. She was then asked what she would sec and hear if she walked into the word. She said that she walked into a landscape where she heard the final part of Gustav Mahler's second symphony. She was asked whether she was with someone or alone. When she mentioned whom she would have liked to be with she began to cry.
A commonality in these questions is that one searches for what is inside the expression; in the word; in the feelings; in the movements, and so on. One does not ask for what is behind or under or over but what is in the expressed. And that requires that the listener see and hear what is expressed.
These questions, which the clients surprisingly often like, are actually very sensitive in that focusing on such words is sensitive. I do not take it for granted that anyone can talk about these words right away because the emotions in them might be very strong. Therefore, I find it safer to introduce a few "outside" questions before "looking-into-rhe-words"questions. For example, the lady who talked about independence was first asked, "How was that word 'independent' expressed [in your family], was it in the open or was it implicit?" She said it was in the open. Then a second question: "Wis it such that you should be independent or was it independence in general?" She said that she should be independent. As she replied to both of the questions she stayed with the word; she did not avoid speaking about it. Her ability to stay with the word told me that she was ready for the next question: "What do you see if you look into the word?"
An important prerequisite to being able to both hear and see carefully and precisely is for the listener (e.g., the therapist) to avoid thinking that the person who speaks means something else than what he/she says. There is nothing more in the utterance than the utterance; there is nothing more said than what is said; there is nothing more shown than what is shown. Nothing more.
Other, even simpler questions also have value, namely, after an introduction: "I noticed you said this or that . , ." and thereafter: "Can you say more what you were thinking when you said that?" or, "What flew through your mind when you said this or that?"or even more simply, "Can you say more?" Other possibilities are: "If you were to choose a word that is very similar [this or that word] what might it be?" or, "If you should choose the opposite word what would that be?" Alt are questions that can elicit nuances so that we might see and hear more
26
- THE REFLECTING PROCESS -
- Acts of Informing and Fanning -
27
than we previously could sec and hear. However, these questions do not escape the overriding question: "Is this an appropriate unusual question or is it too unusual?" And the answer to that question is found, as I hope the reader has grasped, in the small signs the other person expresses to let the therapist know whether it feeb uncomfortable or not.
If we accept the idea about the appropriately unusual, how can we increase our sensitivity to the other? A simple procedure might be useful
THE CLIENTS AS CORESliARCHERS ON THE THERAPISTS* CONTRIBUTIONS TO THE THERAPEUTIC TALKS
During the last three years, in collaboration with a team in Hamad, North Norway, and a team in Stockholm, Sweden' I have tried to find a way to increase therapists' sensitivity for their own contribution to therapy (Andersen, 1993).
The procedure is that therapists, a while after therapy has ended (e.g., one year), ask the clients to return to discuss how it was to be part of die therapeutic meetings. In addition to the clients and the therapists, a visiting professional is present. The meeting starts with the therapists underlining that they wanted the discussion. The therapists, or the visiting professional, refer to reports about evaluation of various treatments that indicate that the collaboration that develops between clients and therapists contributes much to the therapeutic outcome, either making it better or making it worse (Lambert, 1989; Lambert, Shapiro, Be Bergin, 1986}. That makes it reasonable to research the therapeutic sessions together with the clients.
The visiting colleague thereafter talks with the therapists about what they want to focus on and clarity during the meeting, while the clients listen to this talk. In the next step the visitor invites the clients to comment on the talk they just heard (between the therapists and the visitor) and also asks them whether there is something from the therapeutic sessions they want to discuss.
The visitor then talks again with the therapists about what the therapists thought when they heard the talk between the clients and the visitor. The reader will probably notice that this is a variation of the reflecting processes.
There is something the visiting professional should bear in mind, namely, that his/her task is to talk about the process of the therapeutic talks and not the contents of these talks. If the issues of the therapeutic talks are touched on, that should only be to clarify the process.
"The nwfnbftn of the tan in Hurtful were Leif Hugo Hansen, Ingebofg Hanien.lbrill Ida Aandaht,indTorgeir Finiij.and in Stockholm, Annie* Fonmanlt,Marianne Dorgcn-gtcn.and Bo M on tan.
If the clients want to talk more about the issues they once talked about in therapy, the visitor should recognize that as a wish to resume therapy and leave that to the therapists. In other words, the visitor should withdraw.
In dealing with the process of therapy the visitor should feel free to raise any questions. However, it seems most interesting for the therapists to talk about those parts of the therapy in which impasses occurred, where there were tense and uncomfortable periods, or when the therapists were uncertain and in doubt or, in hindsight, where the therapists felt they failed.
The clients' comments on such issues might be very valuable. The visiting colleague may be guided by the idea that the therapists now have the opportunity to hear what might have been too unusual for the clients, what might have come at an improper point in time, what might have been talked about in a improper context, and so on, and thereby to become more aware of they should not do again in future work.
Those therapists who have taken part in this "evaluating process" have made some interesting comments:
"The process is as unique as the therapeutic process, but only those questions are relevant that all present can talk about. Standard questions that belong to standard evaluations would be felt as artificial, and I would not have been part of that."
"The experience, the feeling, to sit there and hear how difficult it was for a client to be part of a way of talking that she had not had any impact on, has led me to understand how important it is for the clients) and me to find a way of talking together we both appreciate, before we start the 'real' talk."
"After being part of this I feel more and more convinced that the clients are the best supervisors. This is an alternative to professional supervision. Actually, hereafter I want both."
'This experience has taught me to be inside the therapeutic relationships and also for me to 'move' out of it and look at it all, inclusive myself, from outside*"
"It was very special to be in this particular kind of triangle; in the sense that I felt we came so close to each other. When 1 was listening and felt so close to the clients I thought maybe we should dare to talk more openly what we feel in those moments when we [the therapists] fight with them."
"1 was so surprised how much they remembered from the [therapeutic] talks. I had forgotten most of it."
"It was a unique experience to feel so close and be on a basis of equality."
28 - THE REFLECTING PROCESS -
The clients have not been asked how they felt about this process, but some have spontaneously said that they appreciated learning what the therapists thought about the therapy they once had together. For some, namely, those who left therapy with the feeling that both they and the therapy had failed, experienced this after talk as a repairing process that brought them dignity. The process seemed to serve them well.
The Circle Is Closed
The reflecting processes appears to be a useful practice that is relatively easy to apply and can be used in many different circumstances. It is also a practice that studies itself. Clients and therapists are not only collaborators but also coresearchers. In marry ways I believe this is a good evolution.
REVISED ASSUMPTIONS (PREUNDERSTANDING)
Maybe it is not a waste of time to discuss whether the reflecting processes represent an alternative way to reach knowledge, and maybe it even brings forth alternative knowledge? Maybe the reflecting processes can be regarded as an alternative, in correspondence with much else in the so-called postmodern period?
Being part of various reflecting processes has definitely contributed to my revisiting certain of my own basic assumptions, and has stimulated me to read about what others have written about these assumptions.
The postmodern era is for some a concept of time, namely, the period after "the modernism " which many say begins with Descartes. For others, postmodernism represents reactions to modernism, not at least the way knowledge is developed and the assumptions on which this way of knowing is based. It is a reaction not only to what kind of knowledge is said to be relevant but also to how this knowledge, and the process by which it emerges, influences us and forms our lives. Several books focus on these issues (see Polkinghorne, 1983,1988; Gergen, 1991, 1994; Kvale, 1992; Shotter. 1993).
In the following discussion, 1 will point to a few, but central, "modern" assumptions.
1. True (objective, correct) knowledge about human beings can be reached (which means that this knowledge is generafizable and applicable for all human beings in all contexts at all points in time).
- Acts of Informing and Forming - 29
2. Human beings function from a basic "inner core" (which one can reach true knowledge about).
3. Language is a tool to express what one thinks (which stems from "the inner core").
4. The language, which must be unambiguous and literal, is in the service of information.
Inspired by the progress of engineering techniques and the progress in the physical sciences, we have been tempted to understand human beings in the same way as we understand those parts of nature that stand still; objective assessments of external signs (utterances and behavior) can mirror and explain the "underlying" (the inner core).
There is a need for experts who know how one can reach true knowledge (the methods), and also possess the knowledge that tells whether what one reached was true or not (know the norms). Collegia are established to protect and make more perfect the methods and the norms.
Quite naturally a hierarchy is developed: experts and nonexperts. This is what I see as a sign of the modern period.
Within the frames of the hierarchical someone became a helper and someone helped;someone a governor and someone governed; someone an observer and someone observed; someone a controller and someone controlled; and so on.
The divisions of people mentioned here separate people not only in terms of their functions but also in relation to privileges. It has been common to claim that the culture of knowledge mentioned above (modernism) was developed in a period of Western culture where economic and material conditions favored persons being independent and self-reliant, and independence and self-reliance became prerequisites for the economic and material life of constant expansion (Samson, 1981).
1 consider a hierarchical culture dangerous because the unevenly distributed privileges so easily create bitterness among the underprivileged, and that bitterness easily creates a desire for revenge. And if the bitterness and the desire for revenge are oppressed, that might lead to more bitterness and maybe even violence.
Alternative Assumptions
I will first mention other assumptions about human beings and humans being- in- the-world.
1. One alternative to the stable and generalizable explanations of human life (e.g., the diagnosis of character disorders) is that a human
}Q - THE REFLECTING PROCESS -
being is constantly shirting and adapts to the various contexts, which in turn (as everybody knows) shift all the time. A person might therefore be understood conrextually at a given point in time. Such understanding of human beings is compatible with the concept of multiple realities: The same person can be understood in many ways—not only the person shifts (talks and acts differently) with shifting circumstances in different periods but also the others who try to understand. Those who try to understand do so from what they see and hear. If the person who understands were to listen to something else (than what he/she listened to and heard) and see something else (than what he/she looked for and saw), his/her understanding would, of course, be different.
2. An alternative assumption to the idea that a person is governed from an inner core is that the person is not in the center but the center of the person is outside him/her, in the collectivity with others. The inner core does not form the individual or the collectivity, but the collectivity forms the individual and the inner core; if this inner core exists at all (Shorter, 1993). Significant in the collectivity arc the conversations that are there, and significant with the conversations are the language the participants of the conversations are in.
3, An alternative assumption of language is that besides being informing, language is also forming. Many have been inspired by what Wittgenstein said, namely, that the language we are in gives the possibilities, on the one hand,and the limitations,on the Other,for what we come to understand (Grayling, 198S). Language will be part of forming what we come to think and understand.John Shatter, inspired by Bakhtin and Vblosvinov, takes this even further and says that the utterances we perform not only form what we come to think but actually form the person as a whole, including the physiological makeup. Inspired by Biilow-Hansen's work and my collaboration with Gudrun 0vreberg I have reached the same conclusions (Andersen, 1993).
Language must be understood as an activity, not only the words that are uttered. "Utterance" is a bigger and more open word than "word." Utterances comprise all that activity that occurs when the spoken word is uttered, and that activity comprises not at least the physical movements and the breathing, the interplay between creating a muscular tension and letting it go. It is in the interplay between letting the tension come and letting the tension go that the forming occurs. What is formed (uttered) may be various things: The sculpture becomes the sculptors utterance; the crescendo the musician's; the widely open, searching eyes with the closed, stiff mouth the refugee's; the disease the patients;and so on. The expressed becomes impression for the person and others (e.g., the painting, the text, the music, the house, the dance, the stone wall, and the patient's record). The
- Acts cf Informing and Forming - J J
impression is, in short, related to what was expressed (uttered), or one might say a result of what was uttered (the product).
Products are given much attention in our culture and are quickly evaluated, for example, as good or bad, useful or useless, expensive or cheap. How it was uttered (to become a product) (i.e., the method or the skill) may also be given attention, even though not as much as the product.
A third aspect of the whole is that the person who expresses herself, by expressing herself as she does forms her life and her selftselves). Because every person is constantly in some kind of activity (i.e., constantly expressing oneself), every person constantly is in the process of being formed—transforming, reforming, or conforming oneself. Shorter (1993) says that an essential part of forming oneself is "positioning oneself" in relation to those who are in the surrounding (i.e., those who see and hear the person's utterances).
Not all I might say and do is acceptable for society. The other who is present, having a notion of what society accepts, will in his/her response to how he/she sees and hears me inform me whether I am within or outside those limits.
It will be in the eyes of the other(s) that we might find an answer to the question about what is or is not acceptable for society. And it is my own response to the other's response that contributes to the forming of me as a responsible person. These limits, reflected in the face of the other, to which I am supposed to respond are tied to the tradition and the culture of society and its surrounding nature.
In the hierarchical culture, the products arc of primary interest, the methods (skills) of secondary interest, lb what extent is there an interest for the individual's being-in-the-world when the skills are applied and the products shaped? I doubt there is much interest.
An alternative to this might be interesting: First, let a society refuse those products that are not acceptable. Then let people, in their forming of various acceptable products (which were not to be ranked according to sales value or standard), search simultaneous formings of their "own selves"; selves they feel comfortable with and are responsible in relation to.
4. An alternative assumption of words as they are heard, spoken, and written on paper is that the words only refer to some other words. It is the French philosopher Jacques Derrida who makes this assumption (Samson, 1989) .Words have meanings in their similarities and differences to other words. The word "dark" will, for example, create a meaning as we simultaneously think of gray or white. Derrida writes that words refer to other words and not to the objects "out there." The particular impression of. "picture" of, or ideas about that which is "out there," and
32 - THE REFLECTINC PROCESS -
which we calk about, are formed by the words we choose for our descriptions.
The Vienna circle in the 1920s, which represented the physical sciences and was much concerned with applying an unambiguous languaget thought metaphorical language should be avoided (Polking-horne, 1983). This opinion has been challenged by many during the last three or four decades by stating that we cannot not talk metaphorically (Johnson, 1987; LakofF& Johnson, 1980). All words (metaphors) are all ambiguous and refer to other words (other metaphors). All words might therefore be nuanced and, after being nuanced, be further nuanced.
At this point I will refer to "the new questions" that I mentioned in this chapter, and which seem to have a certain value in the therapeutic work. For example, "I noticed that you at some time said this or that word. Is that a small or a big word?" If the answer is that the word is big, we might ask: "If the word is so big that you can walk into it, what would you see and hear?" Many interesting "stories" might emerge as a result of such questions.
Talking Habits and Moving Habits
Wittgenstein said that we are in the language. I understand him to mean that the language is not inside us but we are in the language. Correspondingly, I see that we are in movements, in conversations, in collectivities. A collectivity exists in a culture, and a culture is in a nature,
Martin Heidegger's word "being-in-the-world" might be nuanced to life is being-in-movemenrs, being-in-language, being-in-conversa-tions, being-in-collcctivities, being-in-culturc, bcing-in -rutu re.
The person's habits, which exist within these various frames, give possibilities to and limitations for what can be expressed.
A significant matter is to which extent a conversation,a collectivity, or a culture provides new possibilities for new talking and moving habits.
Outer and Inner Dialogues
Throughout his whole (but short) professional life, Lev Vygotsky was preoccupied with the relationships between inner and outer dialogues (Vygotsky, 1988). He thought that a small child at first, in the interplay with adults, learned to imitate their sounds and thereby gained an "outer" language, which means a language that did not yet have personal meanings for the child. However, in the period from approximately three to seven years of age the child develops an "egocentric" language, as the child talks with him/herself during play. Vygotsky noticed that the
—  Acts of Informing and Firming  — 33
presence of a listening adult increased the tendency for the child to talk to him/herself. The adult did not participate in the talk but was present and listened.
Vygotsky regarded this oudoud speaking of the child as a precursor to the inner (not audible) talks where the words have personal meaning. I tend to think that we receive ideas we did not have before from the outer talks, and that our inner talks (with ourselves) sort out which of the new ideas we want to include in our talking habits.
Bakhtin points to the significance of the responses our utterances evoke in those who listen to and see them (the utterances). Wc might both expand our habits of uttering and have them corrected by the responses from the other(s).Simply spoken,one cannot see one's own face when the face utters something (and the living face is such a crucial part of the utterances), Bakhtin thinks that the closest we can come is to see our face reflected in the eyes of the other. And the same will be for the other. One "lends one's eyes to the other."
Three types of inner talks must be mentioned. The first is those we have in our dreams; they are richly composed of rapidly changing "scenes" where most of what happens (everything?) is experienced simultaneously. The second is those we have in daily life when we talk inaudibly with ourselves; those are more coherent than dream talks but sometimes disruptive. The third is those with ourselves when we write: The writing forces us to form longer and more coherent sequences. Writing, for example, about our own work, might therefore give a significant and alternative perspective compared to that which emerges when talking to another. Be reminded of what I wrote earlier about multiple perspectives, with which Gregory Bateson was preoccupied, and differences (between the various perspectives) that make differences (in the particular perspectives).
If the Language Forms, It Forms the Person Who Speaks
One might enter the observer's language and become distant and cold, the language of the participant and be near and warm, the language of the technician and become standing still and lonely, or the language of religion and become distant and violent.
Whatever question one asks is chosen from many possible questions, and whatever answer is one of many possible answers. Every question raised and every answer given can therefore be regarded as limiting the possible (a process of simplification).
The metaphors one selects to construct one's questions and answers
34 - THE REFLECTING PROCESS -
will be likely limiting in the same way as the scientists method is limiting in his/her search for knowledge.
A saying such as "Many senile people suffer from depression" will create a certain understanding by the person who hears these words. A simple reformulation, "Many who seem to be senile arc lonely," most probably creates another understanding, maybe even an understanding that provides ideas about how to relate to the senile person. A further reformulation is, "Many elderly people who find it difficult to take part in conversations appear lonely." These three formulations indicate that the language (the utterances) might be part of forming both "the helper" and "the helpless," in making them either more incompetent or more competent.
When the Language Creates Deficiency
Gergen (1990a, 1990b) seems to be the first to have mentioned "deficiency language" (e.g., the language of pathology). This language, first developed by professionals,has become everyday language for everybody Goolishtan organized the second Galveston conference in San Antonio, Texas—with the tide "The Dts-Diseasing of Mental Health"-—together with Harlene Anderson in November 1991, shortly before he died. In the announcement of the conference one can read:
The central theme of this conference will be the exploration of the Wittgensteinian concept that the limits of the reality that can be known are determined by the language available to us to describe it. This theme will permit us to dialogue around the implications of the "deficiency language" of the mental health field and the effect these words have on our theoretical, clinical and research work. This theme will also address the pragmatic distinction to be made between the concepts of constructivism and social constructionism.
It is our impression that over the last century of the mental health movement we have contributed thousands words to the vocabulary of the world. Unfortunately, most of these contributed and constructed words reflect some central sense of deficiency, Tt seems that in many ways the deficiency language has created a psychological and theoretical reality that can be metaphorically described as a black hole. This is a socially constructed black hole out of which there is very limited escape for meaningful clinical and research activity.
Alternative Descriptions
What might happen if we, the professionals, started to mention and describe what we do in a different manner?
— Adi of Informing auA Forming — 3S
It is quite usual to say that during a conversation, one is listening and one is talking. What would happen with our conversation if we were to choose other metaphors and, for example, say that the person who listens is touched by what the other expresses (utters)?
The person who becomes touched will, the next time, be moved. However,the person will not be passively moved.The person will actively take part in the sense that he/she will be active in the moving of him/herself. One way to clarify what the moved person wants is for that person to search through the language to find how to understand the situation and what to do. The next would be to express that meaning. The expression, in turn, will be a touching of the other(s).
Touching* might take many forms'.stroke,press,push,grab,hold,hit, and so on. If we were to "look into" the couches we give others when we utter something, which of the words above (or other words) would we see?
I imagine that there is a wide spectrum of possibilities, and maybe only the endpoints should be avoided? On the one end to avoid not touching (overlook and ignore) and on the other end to avoid clenching fiercely or pushing away? Which other word might be found in the words: overlook, ignore, clench fiercely,and push away? Maybe our responsibility should make us constandy search for what shall limit us from the endpoints?
The corresponding endpoints for the listener might be to avoid not being touched and moved on the one end and on the other end to escape being held and being pushed away?
The more I write (and think) about this the more it all becomes a matter of a collective responsibility.
Assumptions Have to Be Chosen
In this chapter the word "assumption" has been used purposely several times. Much of what we consider good or bad.right or wrong, or essential or nonessential is based on our assumptions of being so. Assumptions of these kinds cannot stem from something observed and assessed. They are rather results of our speculations, or if we dare to use a bigger word, of what we reach through our "philosophizing." Ukbster's Dictionary defines philosophy as "a search for a general understanding of values and reality by chiefly speculative rather than observational means." Much in "therapy" and "research" and in everyday life concerns knowledge based on assumptions we have already made. The choice of underlying assumptions (preunderstanding) is what I call philosophical choices. Koesder (1964) calls these the ego, the collectivity, the language,the conversations, the emotions, the desires, the talking, the listening, the expressed, the
36 - THE REFLECTING PROCESS -
created, the formed. The new, or what might contribute to the new, comes from combining what we already know in new ways.
It is in this respect that the assumptions become significant, as docs the choice of assumptions. Which of the bits are essentia] and which of the bits should be put together with other bits in which way? In the end, these questions comprise choices about which assumptions we find most useful.
What might help in this search is to participate in various conversations as we work with the following question: "Is that with which I am occupied the most essential or is there something else that is more essential?"
Words at the End
It would be interesting to speculate on how the body participates in creating meaning. Johnson (1987) discusses how the body is thought to perceive (sense) shift in the surroundings before the thought has grasped it. He thinks that the sensing is connected to something learned in the very early part oflife; the body senses the difference,for example, between out and in; between up and down; between being against a force and being with a force. The earliest experiences of sensing become habits and basis for the metaphors we later develop (learn from others) in language, through which wc become "ourselves."
It is also tempting to speculate on how our understanding of the other becomes an expectation that he/she lives up to (Jones, 1986). The others eyes,in this sense, do not passively mirror (reflect) me. It therefore might be useful to consider which others eyes one is to borrow, so that one does not borrow them from whomever.
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