THE ART OF WITHNESS:  A NEW BRIGHT EDGE

Lynn Hoffman

“Living utterance becomes an active participant in social dialogue.  If we imagine such a word in the form of light, then the living and unrepeatable play of colors and light on the facets of the image that it constructs can be explained as the spectral dispersion of the ray word, in an atmosophere filled with the alien words, value judgments and accents through which the ray passes on its way to the object; the social atmosphere of the word, that atmosphere that surrounts the object, makes the facets of the image sparkle.” 

The Dialogic Imagination:   Four Essays by M.M. Bakhtin , M. Holquist (ed), tr.C. Emerson, University of Texas Press, 1981, P. 277 

Introduction:   The New Bright Edge

The image that propelled this title was given to me by Tom Andersen, who kept telling me that I must come to the North of Norway in the “Darktime.”  So he invited me for the first day of spring, just as the sun was going to appear.  The occasion was a meeting of Andersen’s “Northern Network,” composed of teams handling acute breakdowns from hospitals in countries all across Europe’s northern rim.  Andersen took me to his top floor office at the University of Tromso the morning of the conference, and out the window I saw the first rays.  They appeared in the cleft of two snow-covered mountains, then faded away, followed by colors of pink, mauve, and gold which lit up the edges of landscape and sky.   

From time to time as I have passed through the history of this field, I have been given the chance to see such first rays.  And I have in some way known or guessed which newcomer approaches would establish themselves and persist.  One is taking shape now, like a ship hull-up on the horizon.  It has already been referred to as the “Conversational Therapies,” a term used by Roger Lowe (2005) in a recent article.  Lowe distinguishes between the approaches that use “structured questions” like Narrative and Solution-Focused work, and what he calls, following John Shotter (Shotter & Katz, 1998), a “striking moments” approach, which does not use pre-planned techniques.  I am interested in establishing a train of forebears for this last effort, which is now branching off into the future in interesting ways but includes some distinguished ancestors.   

The work of these forebears was illuminated by Gregory Bateson (1972), who at the end of his life emphasized the nonverbal communication styles of what he called the “Creatura,”or the world of the living.  Putting these ideas

to work, Harlene Anderson and Harry Goolishian (1986) took a sharp turn away from purposeful interventions in their “not knowing” stance.  Then Tom Andersen (1990) introduced the “reflecting team,” which inspired those of us like Peggy Penn and myself who were trying to work in a less instrumental way.  

More recently, we have been introduced to a cornucopia of philosophical treasures based on the writings of Ludwig Wittgenstein and Mikhail Bakhtin.  We have a new “in-house philosopher” in social thinker John Shotter (1993), who has described how these writers can help us understand what Bakhtin (1990) calls “dialogicality.” We are beginning to have new terms for what we do, like Tom Andersen’s idea of “withness practices.” We also have some unusual examples of these ideas embedded in the work of innovators such as Jaakko Seikkula and his colleagues in Finland, who have been developing an approach called “Open Dialogue,” joined by Mary Olson, who is teaching dialogic network therapy at the Smith School of Social Work.  Finally, let me mention Chris Kinman in Vancouver, who has been experimenting with a Language of Gifts that is producing entire system change in local areas.  But let me go back in time, and talk about the early genius who started it all: Gregory Bateson. 

Bateson and Syllogisms in Metaphor

There were several philosophical pioneers in the last century who made it their life’s work to study how the forms of Western discourse entangle us.  The two most important ones, in my view, were  Ludwig Wittgenstein and Gregory Bateson. In Wittgenstein’s (1953) famous book of arguments with himself, “Philosophical Investigations,” he explores ways to get out of the invisible linguistic trap he called the “fly bottle.” His work has generated an industry of explainers.  Bateson’s writings have not yet called forth such an industry, but he took on a similar charge in describing the style of nonverbal communication that is common to religion, humor, some forms of madness, playfulness, and art.   

This  type of communication, Bateson held, applied specifically to what Jung called the “Creatura,” the world of the living, as opposed to the “Pleroma,” meaning Newton’s world of force and mass.  The Pleroma has no mental process, no names, no classes.  The Creatura, on the other hand, is founded on pattern and communicates through “as if” language, using similitude and metaphor in a variety of embedded and embodied ways. Bateson’s daughter Catherine (Bateson and Bateson, 1987) tells us that, at the end of his life, her father was fascinated with what he was calling “syllogisms of metaphor.” This idea, she explained, was tied in with the central concern of his research, which was “the beginning of a Creatural grammar.” (Angels Fear, p. 192)

So what might that mean?  In contrasting the truths of logic with the truths of metaphor,  Bateson explains that classical logic describes causal word structures called syllogisms that are built on classification and which follow the form: “if this is true, then that is true.” If Socrates is a man, and if all men die, then Socrates will die.   But there is another word structure that Bateson describes that is built on likeness, the example for which is: “Grass dies, Men die, [therefore] Men are grass.” Logicians disapprove of this kind of syllogism because it does not make sense (they call it “affirming the consequent”), but Bateson believed that this formula indicated the way the natural world communicated. He  fires off this ringing salvo: 

“The whole of animal behavior, the whole of repetitive anatomy, and the whole of biological evolution - each of these vast realms is within itself linked together by syllogisms in grass - whether the logicians like it or not...And it became evident that metaphor was not just pretty poetry, it was not either good or bad logic, but was in fact the logic on which the biological world had been built, the main characteristic and organizing glue of this world of mental process that I have been trying to sketch for you...” (Angels Fear, pp. 26-30) 

This statement thrilled me.  It felt accurate, and it justified the enormous importance my community placed on  sensory pathways and emotional gesturing in the work we did.  It also justified the efforts of philosophers like Wittgenstein, mentioned above, in not only searching out an alternative logic but finding that it could be strikingly different from the classical logic that Western thinkers had come to see as the norm.  The nonverbal, analogical vision of Bateson seemed especially pertinent to the project of psychotherapy, because it indicated that advice and expertise were not enough; you had to reach for connection at levels that lay beyond the scope of words.  

In fact, I felt that Bateson was saying that there is a hidden language known to animals and mad people and artists.  Current researchers in neurology (Damasio, 1994) have pointed to a specific area of the brain - the amygdala (also called the “emotional brain)  saying that this is the brain’s “smoke alarm,” because this is where the intense memories are stored that warn us away from bad things and toward good ones.  It makes sense to believe that messages directed toward this area have to use this ancient grammar of Nature or they may not be recognized. Of course, when Bateson talked about syllogisms in metaphor, he didn’t mean that we should literally use figures of speech, but rather that sensory and feeling-level channels must be used to carry messages of life importance, as the channels of reason and logic are untrustworthy.     

 I also want to say that such messages can break through private walls. Why is this emphasis on the wider web so important for a therapist?  Because it turns us away from looking at individuals and their inner life, which is what modernist psychology trains us to do, and points instead to the threads that link everybody to the social web.   If you stay with modernist psychology, you will forever be trying to see your job as a matter of building  roads, putting up bridges, and various other engineering projects.  If you move to a postmodern psychology, you have to jump, like Alice, into the pool of tears with the other creatures.  This situation is a great equalizer and carries some dangers, but it is the only source of information with the power to transform.  

My Three Pillars of Wisdom

But let me move back to what I call my Three Pillars of Wisdom, the three major anchors of the kind of work I and my community do.  These are the practices that have signalled the shift from a modernist view that sees emotional problems as within-person phenomena like medical complaints, and the postmodern view that they are relational and dialogic in nature.  The first pillar is the idea of “not knowing” brought into the field by Harry Goolishian and Harlene Anderson.  I once asked Harlene if they took it from the writings of the French philosopher Gaston Bachelard (1964), who speaks of “non-knowing” and defines it: “not as a form of ignorance but a difficult transcendence of knowledge.” However, I was wrong.  Harlene told me that they began to use the phrase because their students would ask why they did something and they would always say they “didn’t know.”  Finally, they made a principle out of “not knowing,” to the scorn and derision of much of the field.  But this simple concept made a difference in basic stance that was extremely powerful.  

As an example of the still-unfolding nature of this tradition, let me include a recent article by Peter Rober (2005), who suggests  that “not knowing” has two aspects:  the receptive one of listening, which is assumed in the original concept, and the reflective one of responding. He offers the Bakhtinian notion of the “dialogical self” in order to include these voices that are elements of a therapist’s interior conversation.  I like this expansion of the original idea.  In taking up the term “generous listening” from Lois Shawver (Hoffman, 2002), it struck me that there was a parallel operation that  included thoughts that came up from the “deep well” and that seemed to be evidence of increased psychic attunement.   When I would check these thoughts out with the persons I was seeing, their importance would often be confirmed. 

My second pillar is the practice called the “reflecting team,” contributed by Tom Andersen (1987) and his colleagues in Tromsoe, Norway.  This format

challenged the methods favored by early family therapists, undermining the one-way screen and other devices that walled the family off from the professionals dealing with them.  Asking a family to comment on the reflections of the professionals was even more unheard of.  Before he died, Harlene Anderson suggested to Tom that he broaden the term to “reflecting process,” feeling that  to link this format to a specific method was limiting.    

The third pillar is witnessing, a concept that partially came out of the reflecting team and which I call, following Harlene, “witnessing process.”  There is some internal history of the field to report here.  Soon after Tom Andersen went public with his reflecting format, Michael White adopted it too. In line with his preference for anthropological rather than psychological language, White (1995)  used anthropologist Barbara Meyer’s term “definitional ceremony” to describe it.  He saw that having an audience for his type of therapeutic interview might be used to reinforce the experience of a more inspiring identity.  Experimenting further with this form, he created what he called an Outsider Witness Registry,  where persons who had already worked with him could be invited back to help others in similar situations.  As soon as I began to use reflecting teams, I too was struck by the layering power of the  many voices and groupings it put into play.  It was a prismatic endeavor, where one moment’s witnesser became another moment’s witnessee.  But White’s language threatened to muddy the waters.  As with the reflecting team,  we needed a term that didn’t belong to any one person or school.  “Witnessing process” was a suitably large tent under which many of us could fit, regardless of our therapeutic loyalties.   

 And here I would like to thank philosopher/clinician Lois Shawver (2005) for a new insight.  She has spent years studying Wittgenstein’s ideas and applying them to her views of postmodern therapy.  Recently, during a conversation on her Postmodern Therapies List, she made a distinction between “theories” and “language games,” ( Wittgenstein’s invention) saying that the latter is more useful to those of us trying to describe therapy approaches because it chooses such a specific set of descriptors.  In regard to White’s use of  witnessing, it feels better to me to say that his ideas come out of a different language game than Andersen’s do, rather than saying that White is a deconstructionist and Andersen a social constructionist, for example.  But this is a digression - let me go on to some of the novel ideas toward which Andersen is directing our attention.  

The Contribution of John Shotter

A primary source of this new bright edge I am talking about comes from John Shotter (1993), a postmodern social thinker whose writings on the nature of dialogical communication have become increasingly relevant to the relational therapies.  He has been creating a little intellectual whirlpool around the ideas of two philosophers in particular: Mikhail Bakhtin and

Ludwig Wittgenstein, and applying them to clinical practice. In addition, he and Tom Andersen have been giving workshops together, and this has been a happy development.   

For my part, I felt that Shotter was our in-house philosopher. He was leading us away from the belief that we could change social reality by purely linguistic means.  In its place was a picture of communication as a more bustling, jostling enterprise.  Shotter (2005a) speaks of “embodied knowing” versus “language-based knowing” and describes it as “the sense that addresses itself to feelings of ‘standing,’ of ‘insiderness or outsiderness’ in any social group.”  He says it’s not a skill or a theoretical knowing, but has to do with the anticipations we bring to a conversation, and the influence these impressions have on us and others.   

This development seems to have led Shotter (2005b) to move away from social constructionism, which was the theory we had given most credence to.  He feels it is lacking in any description of the constraints inherent in social exchange.  In his view, communication is like a kind of social weather.  It fills our sails, becalms, or sometimes wrecks us.  Sensing what is called for in a particular context, responding appropriately to gestures like an extended hand, feeling a black cloud settling over a discussion, are all examples of a weather system that can impact us in concrete and material ways.  The truth is that the famous “linguistic turn” of social constructionism gives us almost too much flexibility in what is or is not possible. This is the reason many people have accused it of being “relativistic,” if not morally delinquent.  And there are particular reasons why therapists can feel liberated by giving it up.  The move to a sublingual vocabulary, like pills that melt under the tongue, often brings us closer to the matters that therapy tries to address. 

For instance, Shotter points out that people with emotional problems do a lot of gesture talk and often the problem itself is gesture talk. For this reason, he is very keen on Wittgenstein's appreciation of this more hidden realm.  He quotes Wittgenstein as saying “The origin and primitive form of the language game is a reaction; only from this can more complicated forms develop.” Expanding this thought, Wittgenstein says “that this sort of behavior is prelinguistic:  that a language game is based on it, that it is the prototype of a way of thinking and not the result of thought.”

Shotter feels that the move toward embodied knowing also takes us away from Descartes and the Western tradition. The Enlightenment valued the objective eye of the observer.  In contrast, dialogical reality is based on the shared subjectivity of the participants.  Instead of a “representational” understanding, Shotter offers a “relational” one.  Instead of seeking to be a master and possessor of nature, as Descartes wished to do, Shotter wants us

to respect its “shaped and vectored” qualities.  He further observes that in matters that concern the world of the living,  many important things occur in meetings. All the more reason that we should scrutinize the kind of talking that goes on in them.  Not all  meetings make the kind of difference psychotherapists are looking for, and it behooves us to examine what is the special nature of those that do.   

One of Shotter’s biggest contributions from this point of view has been to translate the lofty abstractions coming from Bakhtin and his colleagues into more ordinary terms.  For instance, he turns Bakhtin’s concepts of “Dialogical” vs. “Monological” thinking” into “Withness” vs. “Aboutness” thinking.  In a recent article (2005b) Shotter says that “Withness Thinking’ is “a dynamic form of reflective interaction that involves coming into contact with another’s living being, with their utterances, with their bodily expressions, with their words, their works.”  In contrast, “Aboutness” or “Monological” thinking” turns the other person into an object, not into a being with a consciousness of its own. 

The beauty of the notion of “dialogicality” or “withness” is that it addresses the criss-cross of merging and overlapping voices, and their silences too, in normal, ordinary exchange.  Instead of the “expert” individual being assigned the most influence in this activity, as usually happens in psychotherapy, a “withness” conversation allows voices to emerge that have often been stifled or withheld.  Attempts to manage meaning may be the norm in our societies, and many psychotherapy models have been built on such attempts, but in these circumstances “withness” does not automatically occur.  In fact, there are some who say it is more apt not to occur. In thinking back on an interview, the best outcome is that people would feel the conversation itself was the author of what was said.   

The “Withness” Practices of Tom Andersen

These ideas fed into my own belief that our theory had to take the mysterious world of the senses more into account.  I was using the idea of “underground rivers” to depict the sensory channels that flow between people when they seem to be connecting.   I also looked back at my own journey, from an emphasis on sight in “The Art of Lenses,” to an emphasis on hearing in “Exchanging Voices,” to the current move toward touch and feeling.  Andersen, of course, had always been persuaded of this emphasis.  Influenced by the late Aadel Bulow- Hansen and Gudrun Ovreberg, two well-known physiotherapists in Norway. Andersen (1986) has always placed the body at the center of his work As a result, he is attentive to breathing; to posture; to tone of voice, as well as to his own inner and outer voices and what is going on in his own body.  He says:     

“The listener (the therapist) who follows the talker (the client) not only hearing the words but also seeing how the words are uttered, will notice that every word is part of the moving of the body. Spoken words and bodily activity come together in a unity and cannot be separated...the listener who sees as much as he or she hears will notice that the various spoken words “touch” the speaker differently...  Some words touch the speaker in such a way that the listener can see him or her moved.” (1996, p. 121) 

In another article, Andersen (?) follows the action of an interview he did in Finland step by step.  He first describes his talk with the host team, who tell him about a mother with two daughters, one of whom, age 19, was “hearing voices.” The team said they were worried because so many other persons in that family had been hospitalized for psychosis.  Andersen said he could always meet with the team alone, if that was what they wanted to consult him  about, but asked if it would not be better to  find out from the mother and daughter directly what their own concerns might be.  The team agreed.     

After asking the translator what her preferred method of working might be, Andersen went on to describe the body language of the mother and daughter as they came into the room.  The mother seemed very preoccupied, the daughter withdrawn.  After hearing about various concerns -  the daughter’s refusal to go to school, the history of family members’ hospitalizations, the mother’s divorce from the father ten years before, Andersen asked the mother if she had any other children.  She said yes, from a former husband, whose parents raised this daughter and kept her from her mother.  The daughter had become a street person, taking drugs, but now she had written to her mother, asking to come live with her.  Andersen asked the mother if she thought the daughter had missed her, and was told yes.  Did she in turn miss her?  Yes.  The sister nodded yes too.   

Andersen then said, “It sounds like your daughter is lonely.” When the mother confirmed this, he asked her if she too were lonely. At this point she said, “I have so much pain.”  Andersen asked where in her body was the pain. “In the heart and in the thoughts.”  “If the pain found a voice what would it say?”  “It would scream.”  With words or without words?”  The mother only looked at him.  Andersen asked “Who would you like to receive your scream? She said, “God.”  “How should God respond to your scream?”  She said she hoped God could take care of her three daughters.  A long pause followed, and a long silence.  The audience seemed very moved, as was Andersen himself.   

In the next part of the interview, Andersen found out that this mother had no adults in her life that she could talk to;  she had no one else but her daughters.  She had been close to her father’s parents, but they were both

dead.  If they had been here, might they have helped her?  Might she have been able to scream to them instead of God?  She began to weep, saying yes. Andersen asked “If your grandmother had been here, what would she have said?”  The mother answered:  “Little girl, you have been so good to your daughters.”  Andersen: “What would you say back?” “Grandmother, I love you so much.”  And what would Grandmother then do?  “She would put her arms around me and I could smell her.  She smells so good.”  Many people in the audience were now openly weeping.  Andersen asked the daughter what her thoughts were.  She said she knew her mother was in pain, but did not know much about her grandparents.  She said that she would rather hear about the pain than not hear anything.  

Andersen closed the interview with a suggestion that the mother take her two daughters to the grandparents’ grave and talk to the girls about them.  Andersen then asked the team and the audience to share their thoughts with him, while the mother and daughter listened.  The team said they had been very moved by the mother’s feelings for her daughters.  Andersen asked if there was a grandmother’s voice in the audience, and found one; then he asked for a grandfather’s voice.  These persons said that they had also been moved, and the grandmother said how important it was for a granddaughter to have a grandmother and for a mother to have a mother.  Mother and daughter left the meeting “with firm handshakes and firm looks,” and Andersen was told by a team member three months later that the daughter had no more fears or voices and was going to school in the fall.   

 In Andersen’s commentary on this interview, he describes his work as a communal enterprise rather than an individual-oriented one, and makes this very interesting point about language:   

“Language is here defined as all expressions, which are regarded to be of great significance in the above-mentioned communal perspective.  They are of many kinds, f.i. to talk, write, paint, dance, sing, point, cry, laugh, scream, hit, etc., are all bodily activities.When these expressions, which are bodily, take place in the presence of others, language becomes a social activity.  Our expressions are social offerings for participating in the bonds of others.”   

I like that idea, as it underscores the “networks talking to networks” idea that we will be seeing in the work of Jaakko Seikkula which I will be describing next.  But first, I want to comment on Andersen’s ability to connect on a mind/body level.  The late (and much-missed) Gianfranco Cecchin used to mock me for my interest in the idea of “empathy.” “Why do you need empathy?’  he used to ask.  “What is so important about this empathy?” I tried to tell him that this is a word I use interactively, and that I call it “tempathy,” for “traveling empathy.”  

My insight was validated when I recently read about cells within the brain that researchers like Anthony Damasio (2003) call “mirror neurons.”  For example, scientists  at the University of Groningen (The Economist, May 14, 2005) have found an action-sensitive type of cell that fires not only when a rhesus monkey reaches out for food, but in a different rhesus monkey who sees the first one’s gesture.  Similar experiments with humans are finding the same thing.  In other words, when I see someone who is moved and shows a reaction, some small piece inside my own brain also moves.  It is these action-sensitive cells that are moving.  It is interesting to note that researchers who study autism say that autistic children strikingly lack these cells.  So there is beginning to be some backing for the idea that empathy is more than  a trait in the individual but is central in the formation and reinforcement of the social net.  

The Open Dialogue Approach

Let me move on now and talk about Open Dialogue.  This term refers to the work of a group from Keropudas Hospital in the North of Finland that includes family therapy pioneers Jukka Altonen, Yrj Alanen and Jaakko Seikkula (1995), among others. They have come up with what they call a dialogic approach to persons with first time acute psychosis.  The group’s background philosophy was greatly influenced by the work of Mikhail Bakhtin and his circle.  They have recently concluded a five year outcome study on Open Dialogue in which the statistics of the Keropudas subjects are compared with those of persons receiving “treatment as usual” from a hospital in Sweden.  By “treatment as usual,” they meant  the hospitalization-plus-neuroleptics approach which has become the accepted way to treat  acute breakdowns in many hospitals across Europe.   

This study excited enormous interest.  Five years after it began, 80 percent of the Open Dialogue patients were working, studying, or training for a job and only 20 percent were on neuroleptic medication. In the comparison group, by contrast, 80 percent were on welfare and 80 percent were on neuroleptics.  By design, hospitalization played a much smaller part in the Open Dialogue group than in treatment as usual, and often was avoided altogether.  Repeat hospitalizations were also much lower.  I had to ask myself:  what is the secret of this approach, and how does it work?  

It was then that I heard that Mary Olson, a colleague of mine who was teaching at Smith School of Social Work, had been asked to apply for a Fulbright at Yvaskyla University in Finland.   Tom Andersen had invited me to come to another of his conferences in Norway, and I asked if Olson could come with me.  Since she was a good writer, as well as a good teacher and therapist, I wanted her to meet the Norwegian and Finnish researchers whose work I had been following for so many years.  So I was able to

introduce her to Andersen’s acute team at Tromsoe Hospital, and on getting the Fulbright, she did indeed go to Yvaskyla University and met Seikkula too.  One result of their meeting was an article they co-wrote describing the Open Dialogue approach (Seikkula, J. and Olson, M., 2003). They have now applied for an NIMH grant to set up a pilot program using the Open Dialogue method with children admitted to the Emergency Room at the Community Services Program at UMass Worcester Medical School.  As with the Keropudas Hospital study, it will compare the outcomes of the children’s research group with those of children who are admitted in the ordinary way.   

Networks talking with Networks

Seikkula puts great importance on the meshing between the treatment team from the parent hospital and persons from the social network of the afflicted person.  The hospital team, usually three or four people,  meets as soon as possible, preferably on the client’s own home ground.  Since all staff in Keropudas are required to take a three year course in family therapy, regardless of discipline, it is possible to pull out at short notice an ad hoc team that is on the same page. Hospitalization is often avoided, and so are the heavier drugs,  although of course they are available.  The network meets daily, or as often as needed, until the disturbance has died down.  Later, individual or family therapy might be offered, but the hospital team continues to monitor the situation.

Another important feature is an aspiration that the conversation be “without rank.”  This is a concept offered by Bakhtin, who in his description of dialogism talks about “the development of familiar and intimate forms of address...more or less outside the framework of the social hierarchy and social conventions, ‘without rank,’ as it were.”  (1986, p. 97) What makes Open Dialogue of interest to communication researchers  is the emphasis on developing a shared way of talking.  This means never challenging the strange words of the patient, no matter how irrational, but continuing to puzzle at them in the belief that a more mutual way of wording the situation will evolve. This forestalls the traditional  effect of family therapy meetings, which is often to highlight the gap between the “sick” and “well” members of the family, or the similar gap between the family and the professional.  The end of such disparities would be a key characteristic of speaking together “without rank.” 

Seikkula says that in its early days, their team followed structured methodologies like the Milan Systemic approach, but found that they failed to generate the hoped-for engagement between the team and the family.  Seikkula says:  “We early realized that it was no longer possible to have control over the treatment processes by treatment plans or by family therapy.” Then they heard that family therapist Yrj Alanen in Turku had started to organize open treatment meetings which included the patient in

every meeting about his or her problem, as well as automatically inviting the family in as well. At this point, the group also found that the ideas of dialogism proposed by the Russian philologists Miklhail Bakhtin, Lev Vygotsky and Valentin Voloshinov allowed them to create a description of the open treatment process.  Seikkula (Seikkula and Olson, 2002) puts the matter pungently: 

“Coming into engaged meetings or dialogical meetings (as we started to call them),  means giving up the idea of primarily having control over things and, instead, jumping into the same river or rapids with our clients and trying to survive by taking each other’s hands.” (p. 403-418)   

In their article, Seikkula and Olson make another important contribution by tying the Open Dialogue format to Bakhtin’s concept of “polyphony.”  Bakhtin lays out the difference between a writer like Tolstoy, who wrote from a God’s Eye View, with Dostoievsky’s ability to move in and out of the lives of his characters and speak with their voices.  Bakhtin goes on to talk about the presence in social life of “a universe of innumerable consciousnesses, each with its own world.” A conversation that  expresses these different possible worlds Bakhtin called “polyphonic.”  This seems like an important value if one is hoping for common understandings to emerge that all have participated in making. 

The Meaning of Chronification

The most startling impression I got from the articles that members of the Keropudas team (Seikkula, et. al., 1995) have written about their work was that the  purpose of therapy seemed to be not so much to alleviate symptoms as to prevent chronicity.  It then occurred to me that the term “calcification” might be a more general metaphor.  How often have we used the word stuckness to describe a family’s difficulties?  How often have the problems people come in wih developed a thick, isolating carapace that hardens with time, often trapping other family members within it.   Harry Goolishian and Harlene Anderson used to call this carapace phenomenon a “problem-determined system” (Anderson, 1997) and talked about not solving the problem but dis-solving it.  The Collaborative practice they built on this view was one of the first family therapy approaches to acknowlege it.  Tom Andersen’s deeply gestural work is another.  Now, even more relevant, we have the dialogical network approach coming from the work of Seikkula and his colleagues, which is not only aiming to combat chronicity but dramatically achieving it.   

What also stood out for me was the fact that in the research group treated at Keropudas Hospital, such a large number ended up functioning within, rather than outside, the ordinary world.  Of course, part of their success was due to

the fact that the team limited their work to people who had not had acute breakdowns before.  And since the team’s major aim was for their people to have the chance to re-enter daily life, they did not consider it a failure if every strange behavior were not suppressed.  

All the same, how do the Open Dialogue methods work?  Here is where the “dialogue” element comes in.  As I said above, the team’s overriding idea was to meet daily until the family and the team could achieve a common language to talk about the situation, putting into words what may have come out as a strange and frightening dumbshow.  The theory was that psychotic behavior was gesture talk, with many fears propelling it, and if one could translate the gesture talk into ordinary language, everyone would benefit.  In the usual course of events, a split was likely to develop between the oddly-acting, oddly speaking family member and the rest of the world.  The sequestration provided by hospitalization and the effect of heavy medication was seen to be part of what made that gulf grow.  Meeting on home ground, on a daily basis and with close others, allowed the team to mediate the effect of social alienation  before it got too strong.   

The last time Seikkula came to the U.S., I asked him if he were still working with acutely disturbed people.  He said, “No,”and explained that for some reason the schizophrenic population in his area had dwindled.  He had shifted to working with depression instead.  When I expressed surprise, he said that in the twelve years since Keropudas Hospital began using dialogic methods, the percent of the population in the North of Finland with chronic mental illness had declined from 33 per 100,000 inhabitants, to seven per 100,000 (Aaltonen, Seikkula, Alakare et. al., 1997).  He opined that perhaps twelve years was the time it took for the effect of a method based on interrupting chronification to show up in the larger population, at least in a rural area. 

The Rhizome Connection

Let me move on now to the story of my connection with “Rock the Boat,” an unusual helping business run by Chris Kinman,  family and community therapist and former minister, together with his partner, criminologist Peter Finck.  For 12 years I have been crossing the continent to Vancouver almost on a yearly basis to see what Kinman and Finck are up to.   Like the work I have been talking about above, this process also involved “networks talking with networks.”  

Back in 1994, Chris phoned me and asked me to come out to do a workshop in British Columbia.  While I was there, Chris brought me into contact with the powerful traditions of the First Nations people, particularly the art and culture of the Haida Gwai from the Queen Charlotte Islands.  Chris was

working with First Nations youth and families, and had been fascinated by the ancient ritual of the potlatch, where the idea is to give rather than to get.  It was not surprising to me when he told me that he wanted to work from the idea of bounty rather than the idea of lacks and disabilities. 

Another feature of this work was a strong communal presence.  During a break in my workshop, which was being held in Vancouver, a person in the audience took me into a room filled with green light.  There, in the midst of ficus trees and bamboo, was an astonishing object.  It was a greenish bronze canoe, half the size of the room, and in it a variety of totemic animals were struggling with each other: the raven with the bear, the wolf with the eagle, the crow with the dog, while half-human creatures like the Dogfish Woman, or the Bear Mother, paddled, watched over by the sombre Village Chief with his temple-shaped hat.  I learned that this was the achievement of a sculptor called Bill Reid, who was himself descended from First Nations people.  In this work, titled “The Spirit of the Haida Gwai,” Reid represented himself as the Ancient Conscript, paddling along with the rest.  

Chris also took me to the university bookstore, and introduced me to two French writers, Deleuze and Guattari (1986), who compared the horizontal growth pattern of the “rhizome” (think crab grass) to the hierarchical pattern of the tree, on which so many Western institutions are based.  Another favorite writer was Gaston Bachelard (1994), who came up with the concept of “reverberation” as an alternative to causality.  This idea pushed me back to Bateson’s  Grammar of the Creatura, where transmission of meaning goes along the paths of metaphor rather than through  chains of logical thought.  At this time I also bought a book by Jacques Godbout called “The World of the Gift,” (1998) and remember telling Kinman that he should make “The Language of Gift” a main descriptor for his work.   

Chris then showed me examples of a “Local Wisdom” series he had put together based on sayings from the persons he was working with.  Some of the titles were Local Wisdom of the Mothers, or Local Wisdom of the Kids.  He would transcribe what people said to him and put it into a kind of chapbook.  Sometimes he would intersperse their comments with passages he wrote, or quotes from writers he admired. I felt it gave the people he worked with a special dignity to be set down in print like that.   

 Another innovation Kinman (2001) had come up with was what he called a Collaborative Action Plan.  This document was an alternative to the usual problem oriented intake record, widely used by services in that area.  What was special was that it was organized around the “language of gifts” referred to above.  The first page asked, “What are the gifts and potentials this person can give to the community?”  The second asked, “What are the gifts and potentials the community can give to the person?”  The third page read,

“What are the roadblocks to these gifts and potentials?”  This was the gist of it, although it varied over time.  Kinman told me that just the use of this document altered his relationships with the people he worked with in a very positive way. 

In his wish to acquaint me with his environment, Kinman put me up in an old time resort hotel in the Canadian Rockies.  It was only one night, but it must have cost a pretty penny - well worth it, if the idea was to impress me.  I asked about the work he was doing with young people and their families, and he told me touching stories about his efforts to see the world as they did.  One memorable thing he shared was about a teen-age girl who said to him, “Therapists try to get into your head; counsellors help you bear your burdens.” Or, as he put it, “What the mountain cannot bear, the river takes away.” I liked the idea that therapy might be like the river. We closed our time together with a trip to the Anthropological Museum, the repository of so much First Nations culture and its splendor.  Then I bought a book on the work of Bill Reid, and said goodbye.   

The Fairy Godfathers 

But it was not goodbye.  The following year, Kinman asked me to come out again.  He had organized a meeting that represented the “systems” he was working with:  some parents of kids he was seeing; a group of his trainees; and a few of his colleagues.  At the time I was much influenced by Tom Andersen’s ideas about reflecting process, and thought we could use such a format for our meeting.   What I did was to ask Kinman to sit and listen while I interviewed each “pod” in the circle about their experience with Kinman’s very different way of working.  The parents  said that he was not like the usual  social service worker because he made them feel like helpers and partners.  The students were pleased, because the tools he gave them made connecting with clients so easy.  His colleagues had similar things to say. During all this, Kinman  occasionally tried to break in, but I stopped him.  When all had their say, I turned to him and asked about the impact of what he had heard.  He was obviously full of emotion by this time, and turned to the notes he had taken, offering each person’s idea as if it were a line in an extended poem.  It was an intensely moving experience for all of us.    

Two years later, Kinman asked me to come back again to preside over a meeting that we were now calling “Honoring Community.” This time the gathering was more formal, and Chris introduced me to his new partner, Peter Finck.  Present were representatives of various social services:  some foster parents, two members of a biker group  who directed homes for troubled boys;  a probation officer (the only one there who had a professional degree); some social work trainees; and a group of adults brought over from Vancouver Island by psychiatrist Robin Routledge that was called The Mood

Clinic.  Chris gave an orienting talk, and introduced me, and I then sat with each subgroup and asked about their work.  I was very touched by the different experiences that were presented, and the ideas offered, Because most of the people present would not have otherwise known about the worlds of the others, it became a fascinating conversation, both for those talking and those listening.   

The day before, I had sat in on a weekly conference attended by the group of biker men who were in charge of youth homes.  They all had vivid tattoos winding up their forearms.  Not having been introduced, I felt like a foreign object, but I sat and listened with interest.  A large dog under the circular table kept going from one set of feet to another, finally settling on mine.  At this point, the leader of the group, still without introducing me, asked me for my opinions.  I said that what had most impressed me was their tenderness.   

 Then I ventured something outrageous:  I said, “To me, you are just a bunch of Fairy Godfathers.”  A moment of appalled silence, and then the group burst into a huge roar, looking hard at the leader, the one who had the most impressive tattoos, and who luckily was laughing too.  This man and a colleague came to our community meeting the next day and commented powerfully on their past experience of class prejudice from persons in social service agencies.  But what most caught my eye was a small tag pasted on the shirt of the leader, saying “Fairy Godfather.”   

The conference finished with all of us listening to the Mood Clinic. This was an informal club which played an advocacy role between patients and medical doctors on issues to do with medication and treatment.  Their stories enlisted both our sympathies and a feeling of hopefulness. The event as a whole had given me a depth knowlege of the helpers and workers who toiled, you might say, in the shadows of desperately troubled clients, but kept their optimism intact.  

New Systems For Old

But that in no way prepared me for the next time I was asked to the Vancouver area.  I had kept in touch with Kinman, and every once in a while he would email off to me another one of his writings.  Once he used up a whole roll of my fax paper - yards of it came pouring out of the machine like an endless Chinese scroll.  But soon there was a new addition to the wisdom series which featured the public health nurses of the Frasier River Valley.  And I learned a new story. 

Chris had told me that some nurses from the Frazier Valley Health Area had come to Rock the Boat for advice because they had become disenchanted

with their problem-oriented assessment form.    They had heard that he and Finck had been experimenting with an alternative that was based on gifts.  Apparently, the Collaborative Action Plan was just what they were looking for.  Kinman told me how these women had taken this format and were fitting it to their own practice. To my amazement, it seemed that their supervisors and the bureacracy were supporting them. Then Kinman said that the teaching program in public health nursing at the University of Victoria was also changing.   

Sitting on my hill a continent away, I received these smoke signals, but I still had no idea of their profound implications.  WIthout much warning, Kinman asked me out one more time.  It seemed that they were going to have another Honoring Community meeting built around the achievement of the public health nurses.  So I flew across again, and what I found really staggered my mind.  As soon as I got there, Kinman introduced me to the frontline workers and they told me about their plans for the meeting that was to be held the next day.  Here is an account of what happened. 

First Kinman gave a slide show featuring commentary from the nurses themselves (he stayed up all night to finish it).  Then I sat with a group of frontline nurses who told me how their work lives had been transformed.  Then came key persons from the bureaucracy who were backing this adventure.  Next came some teachers from the public health nursing program at Victoria University who were changing their curriculum.  Lastly, I sat with Marjorie Warkentin, one of the nurses who had helped spearhead the change, together with a young mother who was recovering from a postpartum depression and had agreed to add her voice.   

This was the first time in my 40 years in the field that I had been present at a change at each level of a complex health system:  front line workers, administration people, teachers, and clients.  That last group had usually been excluded from such conferences, except as the Exhibit A in teaching events.  I thought about all the families that had been used to demonstrate family therapy in front of huge audiences since the field began.  But this  young mother was not there as evidence of some clinician’s ability, but in charge of her own story.  She and Warkentin described their experience with this “gift-oriented” approach to human difficulty, and told us what a difference it made to both of them.   

These systemic changes have lasted and I can now bear witness to the newness that shone forth so brightly in the Fraser River Valley Health Authority that day.  Despite the reductive mantle of managed care, shifts like this one continue to inspire hope in those of us who believe that the language game we use makes all the difference.  And there are many of us  who continue to be watchers on that hill!  

The Conversational Therapies

The secret of talk that moves through underground channels is that it operates on a felt-sense level rather than following codified rules for change. In Roger Lowe’s article, mentioned above, the “structured question” approaches are compared to this new style of working which he calls “dialogical” or “conversational.”   I like the term “conversational.”  It suggests a quality of open-endedness together with an emphasis on spontaneity, more like the way a creative artist operates than a licenced professional.  As Andersen says: “My wish is at this moment that we stop talking about therapy and rather talk of it as human art; the art to participate in the bonds with others.”

Whatever we call this new big tent, it seems obvious to me that we have gone beyond  social constructionism’s “linguistic system” idea with its emphasis on the malleability of meaning.  Instead we are looking for “withness practices.” These entail a special kind of exchange.  They bypass the hierarchy implicit in most social interaction.  They do not lead to some pre-determined goal or depend on a pre-arranged technology. If a sense of having “got there” occurs, it must come spontaneously, much as Wittgenstein suggests when he says that the aim of philosophy is to help us know “how to go on.” Above all, they operate on a feeling level, which is the field where goods are struggled for and contests go on, and where a sense of justice is a constant living thing.   

THE GEE’S BEND QUILTS 

Let me end with the story of the Gee’s Bend Quilts, made from scraps of old clothes by the African American country women of Gee’s Bend, Alabama and now hailed as triumphant examples of unexpected folk-art.  The family therapy field is also made of scraps and patches.  Just as the Gee’s Bend quilters used worn-out pieces of material, with their accumulations of history, to create bed quilts, so our movement is made up of pieces of practice from many stages:  structural, strategic, interactional, solution-focused, possibility-oriented, systemic, narrative, reflecting, collaborative, to name just a few.  Now comes a new term, dialogical.  This title suggests an elusive quality called “withness” and is represented by those special kinds of conversation or “language games” that give us our bearings in the matter of social bonds.  There is no end point toward which this movement of ours is trending.  It is only a folk quilt and its only purpose is to keep us warm at night.  But it might not be so warm were it not made of so many patches of history, memories and lore.          

REFERENCES

Andersen, T.  (1987)  “The reflecting team: Dialogues and meta-dialogues in clinical work.”  Family Process, 26, 415-428.  

Andersen, T. (1991) The Reflecting Team: Dialogues and Dialogues About the Dialogues.  New York:  W.W. Norton 

Anderson, H. (1997) Conversation, Language and Possibilities.  New York:  Basic Books. 

Anderson, H., Goolishian, H. & Winderman, L. (1986) “Problem-determined systems:  Towards transformation in family therapy.  J. of Strategic and Systemic Therapies, 5, 1-13 

Anderson, H., and Goolishian, H. (1986) “Human systems as linguistic systems.”  Family Process, 27, 371-393. 

Bachelard, G.  (1964) The Poetics of Space.  Boston:  Beacon Press 

Bateson, G. (1972) Steps to an ecology of mind.  New York:  Ballantine. 

Bateson, G. and Bateson, M. C. (1987) Angels Fear.  New York:  Macmillan.       

Bakhtin, M. M. (1981) The Dialogic Imagination.  M. Holquist (ed.) C. Emerson and M. Holquist (tr.).  Austin:  University of Texas Press.   

Damasio, A. (1994) Descartes’ Error.  New York:  Putnam.  

Damasio, A. (2003) Looking for Spinoza:   Joy, Sorrow and the Feeling Brain .  New York: Harcourt     

Deleuze, G. and Guattari, F. (1986)  Anti-Oedipus:   Capitalism and Schizophrenia.  Minneapolis:  University of Minnesota Press. 

Godbout, J.  (1998)  The World of the Gift.  Quebec, B.C.:  McGill-Queens University Press. 

Hoffman, L. (2002) Family Therapy:   An Intimate History .  New York:  W.W. Norton 

Lowe, Roger  (2005) “Structured Methods and Striking Moments,” Family Process 44, 65-75. 

Kinman, C.  (2001?) The Language of Gifts.  Vancouver, B.C.: Rock the Boat Publications 

Lyotard, J-F (1984)  Driftworks  R. McKeon (ed).  Semiotexte   

Rober, P. (2005) “The Therapist’s Self in Dialogical Family Therapy.”  Family Process, 44, 479-497 

Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keranen, J. and Satela, M. (1995)

Treating psychosis by means of open dialogue.  In S. Friedman (Ed.), The Reflecting Team in Action. New York:  Guilford Press. 

Seikkula, J., Alakare, B., & Altonen, J. (2001)  Open Dialogue in psychosis. J. of Constructivist Psychology, 14, 267-284. 

Seikkula, J., and Olson, M. (2003) “The open dialogue apprach to acute psychosis.”  Family Process, 42, p. 403-418. 

Shawver, L.  Nostalgic Postmodernism.  Oakland, CA:  Paralogic Press 

Shotter, J.  (2004)  On the edge of social constructionism:  ‘Withness-thinking’ versus ‘aboutness-thinking.’  London:  KCC Foundation Publications. 

Shotter, J. (2005) “Wittgenstein, Bakhtin and Vygotsky:  Introducing dialogically-structured reflective practices into our everyday life.”  Talk for a conference on Special Education, Copenhagen, May, 2005. 

Shotter, J. and Katz, A. (1998) ‘Living moments’ in dialogical exchanges. Human Systems:  9, 81-93. 

Shotter, J. and Katz, A. (2005) “Poetics and ‘Presence’ in Practice.”  Talk for Kensington Consultation Center Summer School, July 2005.   

Wittgenstein, L. (1953)  Philosophical Investigations.  Oxford:  Blackwell